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General NPI Number Information
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NPI Number | 1760509822
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Entity Type | Organization
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Legal Business Name | FISHER CHIROPRACTIC, INC.
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Dates
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Enumeration Date | 03/23/2007
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Last Update Date | 03/29/2016
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Provider Practice Location Address
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Address Line | 43 CORPORATE PARK STE 204 204
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City | IRVINE
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State | CA
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Zip | 92606-5137
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Country | US
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Telephone | 714-550-0788
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Fax | 714-550-6001
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Provider Business Mailing Address
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Address Line | 43 CORPORATE PARK STE 204
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City | IRVINE
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State | CA
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Zip | 92606-5137
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Country | US
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Telephone | 714-550-0788
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Fax | 714-550-6001
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFF ALLEN FISHER
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Credential | D.C.
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Telephone | 714-550-0788
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111NR0400X
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Taxonomy Name | Rehabilitation Chiropractor
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License Number | DC21320
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License Number State | CA
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