Healthcare Provider Details

I. General information

NPI: 1679658223
Provider Name (Legal Business Name): RICHARD V FISHER DC
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1118 E SUPERIOR ST FISHER CHIROPRACTIC CLINIC LTD
DULUTH MN
55802-2217
US

IV. Provider business mailing address

1118 E SUPERIOR ST FISHER CHIROPRACTIC CLINIC LTD
DULUTH MN
55802-2217
US

V. Phone/Fax

Practice location:
  • Phone: 218-728-3639
  • Fax: 218-728-2603
Mailing address:
  • Phone: 218-728-3639
  • Fax: 218-728-2603

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number1182
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: