Provider Demographics
NPI:1710052162
Name:FISCHER, CAROL ANN (DC)
Entity Type:Individual
Prefix:DR
First Name:CAROL
Middle Name:ANN
Last Name:FISCHER
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29748 MARK LN
Mailing Address - Street 2:
Mailing Address - City:LIVONIA
Mailing Address - State:MI
Mailing Address - Zip Code:48152-4506
Mailing Address - Country:US
Mailing Address - Phone:734-890-1082
Mailing Address - Fax:734-261-9172
Practice Address - Street 1:10950 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-2753
Practice Address - Country:US
Practice Address - Phone:734-664-0339
Practice Address - Fax:734-261-9172
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-21
Last Update Date:2007-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI2301008361111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor