MEDICARE: DR. BRIAN ROSS FISK DC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	111N00000X	Chiropractor	2026	NE

General Provider Information

NPI Number	:	1851936827
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN ROSS FISK DC

Provider Business Mailing Address
First Line	:	1119 JEFFERSON AVE
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-3732
Country	:	US
Telephone Number	:	402-984-3528
Fax Number	:

Provider Business Practice Location Address
First Line	:	422 N HASTINGS AVE # 201
Second Line	:
City	:	HASTINGS
State	:	NE
Zip	:	68901-5169
Country	:	US
Telephone Number	:	402-984-3528
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/13/2019
Last Update Date	:	11/13/2019

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Directions to “ DR. BRIAN ROSS FISK DC” Practice Location

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