Provider Demographics
NPI:1063647212
Name:SCIATICA AND DISC CENTER
Entity Type:Organization
Organization Name:SCIATICA AND DISC CENTER
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:912-335-1601
Mailing Address - Street 1:413 WEST MONTGOMERY CROSSROAD
Mailing Address - Street 2:UNIT 106
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31406-3394
Mailing Address - Country:US
Mailing Address - Phone:912-335-1601
Mailing Address - Fax:912-335-1602
Practice Address - Street 1:413 WEST MONTGOMERY CROSSROAD
Practice Address - Street 2:UNIT 106
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-3394
Practice Address - Country:US
Practice Address - Phone:912-335-1601
Practice Address - Fax:912-335-1602
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-18
Last Update Date:2009-05-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CHIR008015111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty