MEDICARE: DR. BASTIAN FISCHER DC

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	011144	GA

General Provider Information

NPI Number	:	1356106231
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BASTIAN FISCHER DC

Provider Business Mailing Address
First Line	:	70 LENOX POINTE NE STE D
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3140
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	70 LENOX POINTE NE STE D
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30324-3140
Country	:	US
Telephone Number	:	404-600-4117
Fax Number	:

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

Provider Enumeration Date	:	02/19/2024
Last Update Date	:	02/19/2024

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Directions to “ DR. BASTIAN FISCHER DC” Practice Location

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