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General NPI Number Information
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NPI Number | 1093990244
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Entity Type | Organization
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Legal Business Name | DR ELLEN FITZENRIDER PLLC
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Dates
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Enumeration Date | 01/07/2008
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Last Update Date | 01/07/2008
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Provider Practice Location Address
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Address Line | 1906 COLLEY AVE
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City | NORFOLK
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State | VA
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Zip | 23517-1613
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Country | US
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Telephone | 757-627-3657
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Fax | 757-627-2061
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Provider Business Mailing Address
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Address Line | 1906 COLLEY AVE
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City | NORFOLK
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State | VA
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Zip | 23517-1613
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Country | US
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Telephone | 757-627-3657
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Fax | 757-627-2061
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Authorized Official
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Title or Position | OWNER
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Name | DR. ELLEN E FITZENRIDER
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Credential | D.C.
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Telephone | 757-627-6357
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State | VA
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