Healthcare Provider Details

I. General information

NPI: 1568534345
Provider Name (Legal Business Name): WILLIAMSBURG CHIROPRACTIC OFFICE, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 02/19/2024
Certification Date: 02/19/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

331 S 5TH ST
WILLIAMSBURG OH
45176-1004
US

IV. Provider business mailing address

331 S 5TH ST
WILLIAMSBURG OH
45176-1004
US

V. Phone/Fax

Practice location:
  • Phone: 513-724-1600
  • Fax: 513-724-1601
Mailing address:
  • Phone: 513-724-1600
  • Fax: 513-724-1601

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number3010
License Number StateOH

VIII. Authorized Official

Name: TRAVIS DAIL FISHER
Title or Position: CHIROPRACTIC
Credential: DC
Phone: 513-724-1600