Provider Demographics
NPI:1376721118
Name:FISHER, MICHELLE ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:ANN
Last Name:FISHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:DR
Other - First Name:MICHELLE
Other - Middle Name:ANN
Other - Last Name:FISHER-ROTHERY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DC
Mailing Address - Street 1:4079 TONGASS AVE
Mailing Address - Street 2:SUITE 102
Mailing Address - City:KETCHIKAN
Mailing Address - State:AK
Mailing Address - Zip Code:99901
Mailing Address - Country:US
Mailing Address - Phone:907-225-7808
Mailing Address - Fax:907-247-7868
Practice Address - Street 1:4079 TONGASS AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:KETCHIKAN
Practice Address - State:AK
Practice Address - Zip Code:99901
Practice Address - Country:US
Practice Address - Phone:907-225-7808
Practice Address - Fax:907-247-7868
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-04
Last Update Date:2023-04-03
Deactivation Date:2019-09-25
Deactivation Code:
Reactivation Date:2023-03-30
Provider Licenses
StateLicense IDTaxonomies
IDCHIA-1292111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor