Provider Demographics
NPI:1598917759
Name:FISHER CHIROPRACTIC CARE LLC
Entity Type:Organization
Organization Name:FISHER CHIROPRACTIC CARE LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CHIROPRACTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DONNA
Authorized Official - Middle Name:L
Authorized Official - Last Name:FISHER
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:205-343-1599
Mailing Address - Street 1:1025 15TH ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:TUSCALOOSA
Mailing Address - State:AL
Mailing Address - Zip Code:35401-3300
Mailing Address - Country:US
Mailing Address - Phone:205-826-0854
Mailing Address - Fax:
Practice Address - Street 1:1025 15TH ST
Practice Address - Street 2:SUITE D
Practice Address - City:TUSCALOOSA
Practice Address - State:AL
Practice Address - Zip Code:35401-3300
Practice Address - Country:US
Practice Address - Phone:205-826-0854
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-21
Last Update Date:2010-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1936261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL1598917759Medicare PIN