| Doctor Name: | THOMAS C LICKLIDER |
| NPI Number: | 1568782860 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | CO |
| License Number: | |
| Business Practice Address: | 132 Forest Ridge Dr Nebo, NC - 287618708 |
| Business Phone Number: | 3147575395 |
| Business Fax Number: | |
| Mailing Address: | 132 Forest Ridge Dr, NEBO |
| State: | NC |
| Postal Code: | 287618708 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 06/09/2010 |
| NPI Last Update Date: | 11/04/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 222Z00000X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Orthotist |
| Taxonomy Specialization: | |
| Taxonomy Definition: | A health care professional who is specifically educated and trained to manage comprehensive orthotic patient care, including musculoskeletal and neuromuscular anomalies resulting from injuries or disease processes involving the lower extremity, upper extremity or spinal segment/s and positional deformation of the cranium. Orthotists assess specific patient needs, formulate an appropriate treatment plan, implement the treatment plan and provide follow-up care. |