Provider Demographics
NPI:1811934979
Name:FISCHER, VIVI-ANN RAE (DC)
Entity type:Individual
Prefix:
First Name:VIVI-ANN
Middle Name:RAE
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 1:3900 VINEWOOD LN N
Mailing Address - Street 2:
Mailing Address - City:PLYMOUTH
Mailing Address - State:MN
Mailing Address - Zip Code:55441-1155
Mailing Address - Country:US
Mailing Address - Phone:763-559-9236
Mailing Address - Fax:763-559-7486
Practice Address - Street 1:3900 VINEWOOD LN N
Practice Address - Street 2:
Practice Address - City:PLYMOUTH
Practice Address - State:MN
Practice Address - Zip Code:55441-1155
Practice Address - Country:US
Practice Address - Phone:763-559-9236
Practice Address - Fax:763-559-7486
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-31
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2236111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
MNFV8610Medicare ID - Type Unspecified