Provider Demographics
NPI:1871745430
Name:CHRISTOPHER LOWE HICKLIN DCPLC
Entity type:Organization
Organization Name:CHRISTOPHER LOWE HICKLIN DCPLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CHRISTOPHER
Authorized Official - Middle Name:LOWE
Authorized Official - Last Name:HICKLIN
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:941-923-4357
Mailing Address - Street 1:3220 CLARK RD
Mailing Address - Street 2:
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-8302
Mailing Address - Country:US
Mailing Address - Phone:941-923-4357
Mailing Address - Fax:941-923-9943
Practice Address - Street 1:3220 CLARK RD
Practice Address - Street 2:
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-8302
Practice Address - Country:US
Practice Address - Phone:941-923-4357
Practice Address - Fax:941-923-9943
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-15
Last Update Date:2011-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLCH3772111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1871745430OtherCORP. NPI
FL050817900Medicaid
FL1760476816OtherINDIVIDUAL NPI
FLT55942Medicare UPIN
FLAY270Medicare PIN
1871745430OtherCORP. NPI