Provider Demographics
NPI:1538488663
Name:FISHER, STEVEN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:STEVEN
Middle Name:JAMES
Last Name:FISHER
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1817 WASHINGTON ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TWO RIVERS
Mailing Address - State:WI
Mailing Address - Zip Code:54241-2625
Mailing Address - Country:US
Mailing Address - Phone:920-553-0328
Mailing Address - Fax:
Practice Address - Street 1:1817 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:TWO RIVERS
Practice Address - State:WI
Practice Address - Zip Code:54241-2625
Practice Address - Country:US
Practice Address - Phone:920-553-0328
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-05-28
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2010014310111N00000X
WI4876-12111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor