Provider Demographics
NPI:1467048215
Name:FISH FAMILY HEALTH LLC
Entity type:Organization
Organization Name:FISH FAMILY HEALTH LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/LEAD DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ZACHARY
Authorized Official - Middle Name:
Authorized Official - Last Name:FISH
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:417-582-7141
Mailing Address - Street 1:5240 N TOWNE CENTRE DR STE 102B
Mailing Address - Street 2:
Mailing Address - City:OZARK
Mailing Address - State:MO
Mailing Address - Zip Code:65721-9075
Mailing Address - Country:US
Mailing Address - Phone:417-582-7141
Mailing Address - Fax:417-582-7147
Practice Address - Street 1:5240 N TOWNE CENTRE DR STE 102B
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:MO
Practice Address - Zip Code:65721-9075
Practice Address - Country:US
Practice Address - Phone:417-581-7141
Practice Address - Fax:417-582-7147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-12-16
Last Update Date:2022-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty