Provider Demographics
NPI:1942345327
Name:FIKE CHIROPRACTIC PAIN RELIEF
Entity Type:Organization
Organization Name:FIKE CHIROPRACTIC PAIN RELIEF
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:DAK
Authorized Official - Middle Name:R
Authorized Official - Last Name:FIKE
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:307-460-9119
Mailing Address - Street 1:1659 N 23RD ST
Mailing Address - Street 2:
Mailing Address - City:LARAMIE
Mailing Address - State:WY
Mailing Address - Zip Code:82072
Mailing Address - Country:US
Mailing Address - Phone:307-460-9119
Mailing Address - Fax:
Practice Address - Street 1:1267 N 15TH ST
Practice Address - Street 2:SUITE 123B
Practice Address - City:LARAMIE
Practice Address - State:WY
Practice Address - Zip Code:82072
Practice Address - Country:US
Practice Address - Phone:307-460-9119
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY582111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYU77419Medicare UPIN
WYW20317Medicare PIN