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General NPI Number Information
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NPI Number | 1861437899
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Entity Type | Individual
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Provider Name | GARY FISCHER PT
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Gender | Male
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Dates
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Enumeration Date | 06/16/2006
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Last Update Date | 05/23/2016
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Provider Practice Location Address
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Address Line | 577 BRAUND ST
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City | ONALASKA
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State | WI
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Zip | 54650-8556
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Country | US
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Telephone | 608-781-7191
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Fax |
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Provider Business Mailing Address
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Address Line | 200 MASON ST STE 17
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City | ONALASKA
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State | WI
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Zip | 54650-7061
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Country | US
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Telephone | 608-781-0174
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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 | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 2406-012
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | 3504-024
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License Number State | WI
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