MEDICARE: GARY FIKE DC CMT CERTIFIED MAS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	08000656A	IN
2	225700000X	Massage Therapist

General Provider Information

NPI Number	:	1336363423
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GARY FIKE DC CMT CERTIFIED MAS

Provider Business Mailing Address
First Line	:	2309 TIMBERBROOK TR
Second Line	:
City	:	FT WAYNE
State	:	IN
Zip	:	46845-9745
Country	:	US
Telephone Number	:	260-637-8016
Fax Number	:

Provider Business Practice Location Address
First Line	:	2309 TIMBERBROOK TR
Second Line	:
City	:	FT WAYNE
State	:	IN
Zip	:	46845-9745
Country	:	US
Telephone Number	:	260-637-8016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/12/2007
Last Update Date	:	09/11/2025

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