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General NPI Number Information
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NPI Number | 1942345327
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Entity Type | Organization
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Legal Business Name | FIKE CHIROPRACTIC PAIN RELIEF
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Dates
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Enumeration Date | 02/21/2007
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 1267 N 15TH ST SUITE 123B
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City | LARAMIE
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State | WY
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Zip | 82072
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Country | US
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Telephone | 307-460-9119
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Fax |
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Provider Business Mailing Address
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Address Line | 1659 N 23RD ST
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City | LARAMIE
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State | WY
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Zip | 82072
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Country | US
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Telephone | 307-460-9119
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DAK R FIKE
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Credential | D.C.
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Telephone | 307-460-9119
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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 | 582
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License Number State | WY
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