Healthcare Provider Details

I. General information

NPI: 1295161636
Provider Name (Legal Business Name): RONALD FISCHER, D.C.-LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 09/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

110 SCHRAMM RD
NEENAH WI
54956-9210
US

IV. Provider business mailing address

110 SCHRAMM RD
NEENAH WI
54956-9210
US

V. Phone/Fax

Practice location:
  • Phone: 920-915-0526
  • Fax:
Mailing address:
  • Phone: 920-915-0526
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111NS0005X
TaxonomySports Physician Chiropractor
License Number2436
License Number StateWI

VIII. Authorized Official

Name: RONALD D FISCHER
Title or Position: PRESIDENT
Credential: D.C.
Phone: 920-915-0526