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General NPI Number Information
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NPI Number | 1760615827
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Entity Type | Organization
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Legal Business Name | FISHER CHIROPRACTIC CARE, LLC
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Dates
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Enumeration Date | 08/24/2009
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Last Update Date | 08/24/2009
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Provider Practice Location Address
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Address Line | 2781 100TH ST
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City | URBANDALE
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State | IA
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Zip | 50322-3863
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Country | US
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Telephone | 309-781-4681
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Fax |
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Provider Business Mailing Address
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Address Line | 2781 100TH ST
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City | URBANDALE
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State | IA
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Zip | 50322-3863
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Country | US
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Telephone | 309-781-4681
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Fax |
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Authorized Official
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Title or Position | OWNER, PRESIDENT
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Name | DR. RENATA FISHER
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Credential | D.C.
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Telephone | 309-781-4681
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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 |
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