Healthcare Provider Details

I. General information

NPI: 1942345327
Provider Name (Legal Business Name): FIKE CHIROPRACTIC PAIN RELIEF
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1267 N 15TH ST SUITE 123B
LARAMIE WY
82072
US

IV. Provider business mailing address

1659 N 23RD ST
LARAMIE WY
82072
US

V. Phone/Fax

Practice location:
  • Phone: 307-460-9119
  • Fax:
Mailing address:
  • Phone: 307-460-9119
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code111N00000X
TaxonomyChiropractor
License Number582
License Number StateWY

VIII. Authorized Official

Name: DR. DAK R FIKE
Title or Position: PRESIDENT
Credential: D.C.
Phone: 307-460-9119