Provider Demographics
NPI:1457531279
Name:HICKS, ANDREW FORREST (DC)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:FORREST
Last Name:HICKS
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7562 S UNIVERSITY BLVD STE B
Mailing Address - Street 2:
Mailing Address - City:CENTENNIAL
Mailing Address - State:CO
Mailing Address - Zip Code:80122-3160
Mailing Address - Country:US
Mailing Address - Phone:303-779-7933
Mailing Address - Fax:
Practice Address - Street 1:9427 S UNIVERSITY BLVD
Practice Address - Street 2:
Practice Address - City:HIGHLANDS RANCH
Practice Address - State:CO
Practice Address - Zip Code:80126-4976
Practice Address - Country:US
Practice Address - Phone:303-779-7933
Practice Address - Fax:303-779-4691
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-08
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7868111N00000X
COCHR.0007360111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ542742Medicare PIN