Provider Demographics
NPI:1710045695
Name:FICHTEL, TODD BARTON (DC)
Entity Type:Individual
Prefix:DR
First Name:TODD
Middle Name:BARTON
Last Name:FICHTEL
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 1:8268 CARROLLTON PIKE
Mailing Address - Street 2:
Mailing Address - City:GALAX
Mailing Address - State:VA
Mailing Address - Zip Code:24333-6132
Mailing Address - Country:US
Mailing Address - Phone:276-236-4878
Mailing Address - Fax:276-238-9856
Practice Address - Street 1:8268 CARROLLTON PIKE
Practice Address - Street 2:
Practice Address - City:GALAX
Practice Address - State:VA
Practice Address - Zip Code:24333-6132
Practice Address - Country:US
Practice Address - Phone:276-236-4878
Practice Address - Fax:276-238-9856
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA1616111N00000X
LA903111N00000X
TX5547111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA215104OtherBLUE-CROSS BLUE-SHIELD #
U14022Medicare UPIN