Healthcare Provider Details
I. General information
NPI: 1326358342
Provider Name (Legal Business Name): HEATHER M FISCHER-BRYANT DC
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/08/2010
Last Update Date: 05/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1335 SOUTHGATE PLZ
MAYSVILLE KY
41056-9132
US
IV. Provider business mailing address
1335 SOUTHGATE PLZ
MAYSVILLE KY
41056-9132
US
V. Phone/Fax
- Phone: 606-564-4213
- Fax: 606-564-4406
- Phone: 606-564-4213
- Fax: 606-564-4406
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | 5258 |
| License Number State | KY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: