Provider Demographics
NPI:1871643882
Name:FISCHER, REBECCA SUE (DC)
Entity Type:Individual
Prefix:DR
First Name:REBECCA
Middle Name:SUE
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 1:3225 AUSTIN BLUFFS PKWY
Mailing Address - Street 2:100
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80918-5767
Mailing Address - Country:US
Mailing Address - Phone:719-380-0222
Mailing Address - Fax:719-380-0221
Practice Address - Street 1:3225 AUSTIN BLUFFS PKWY
Practice Address - Street 2:100
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80918-5767
Practice Address - Country:US
Practice Address - Phone:719-380-0222
Practice Address - Fax:719-380-0221
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-11
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO1771111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO841291037OtherTAX ID
CO841291037OtherTAX ID