Provider Demographics
NPI:1891979464
Name:FISHER, CARRIE JAYNE (DC)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:JAYNE
Last Name:FISHER
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 1:3502 SATELLITE BLVD
Mailing Address - Street 2:SUITE 7
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-5820
Mailing Address - Country:US
Mailing Address - Phone:770-497-8989
Mailing Address - Fax:
Practice Address - Street 1:3502 SATELLITE BLVD
Practice Address - Street 2:SUITE 7
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30096-5820
Practice Address - Country:US
Practice Address - Phone:770-497-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GACHIR007384111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor