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General NPI Number Information
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NPI Number | 1174776058
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Entity Type | Organization
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Legal Business Name | BUZZARDS BAY CHIROPRACTIC, P.C.
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Dates
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Enumeration Date | 10/23/2008
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Last Update Date | 01/29/2009
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Provider Practice Location Address
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Address Line | 196 MAIN STREET
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City | BUZZARDS BAY
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State | MA
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Zip | 02563
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Country | US
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Telephone | 508-759-8852
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Fax | 508-759-0192
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Provider Business Mailing Address
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Address Line | 196 MAIN STREET
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City | BUZZARDS BAY
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State | MA
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Zip | 02532
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Country | US
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Telephone | 508-759-8852
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Fax | 508-759-0192
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. DAVID C FISHER
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Credential | D.C.
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Telephone | 508-759-8852
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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 | MA1748
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License Number State | MA
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Taxonomy #2
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Taxonomy Code | 111NX0800X
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Taxonomy Name | Orthopedic Chiropractor
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License Number | MA1748
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License Number State | MA
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