Provider Demographics
NPI:1306021902
Name:FISHER FAMILY CHIROPRACTIC LTD
Entity Type:Organization
Organization Name:FISHER FAMILY CHIROPRACTIC LTD
Other - Org Name:FAMILY FIRST CHIROPRACTIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:J
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:775-337-0184
Mailing Address - Street 1:2155 GREEN VISTA DR STE 202
Mailing Address - Street 2:
Mailing Address - City:SPARKS
Mailing Address - State:NV
Mailing Address - Zip Code:89431-8512
Mailing Address - Country:US
Mailing Address - Phone:775-337-0184
Mailing Address - Fax:775-337-2395
Practice Address - Street 1:2155 GREEN VISTA DR STE 202
Practice Address - Street 2:
Practice Address - City:SPARKS
Practice Address - State:NV
Practice Address - Zip Code:89431-8512
Practice Address - Country:US
Practice Address - Phone:775-337-0184
Practice Address - Fax:775-337-2395
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-02
Last Update Date:2017-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NVB-808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVV37600Medicare PIN
NVU79282Medicare UPIN