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General NPI Number Information
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NPI Number | 1851378376
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Entity Type | Individual
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Provider Name | TAMMY R. FIMRITE D.C.
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Gender | Female
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 01/11/2020
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Provider Practice Location Address
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Address Line | 203 PARK AVE S SUITE 101
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City | SAINT CLOUD
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State | MN
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Zip | 56301-3779
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Country | US
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Telephone | 320-253-5650
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Fax |
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Provider Business Mailing Address
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Address Line | 203 PARK AVE SOUTH
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City | ST. CLOUD
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State | MN
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Zip | 56301
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Country | US
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Telephone | 320-253-5650
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171100000X
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Taxonomy Name | Acupuncturist
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License Number | 862
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License Number State | MN
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Taxonomy #2
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 4006
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License Number State | MN
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