Organization
FITCH CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VICTOR K FITCH D.C. (OWNER)
(260) 471-7493
Entity
Organization
Contact information
Practice address
3010 E. STATE BLVD, SUITE 500, FORT WAYNE, IN 46805-4700
(260) 471-7493
(260) 471-6935
Mailing address
3010 E. STATE BLVD, SUITE 500, FORT WAYNE, IN 46805-4700
(260) 471-7493
(260) 471-6935
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000206A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100049760
—
IN
01
—
350664222
MEDICARE RR
IN
Enumeration date
05/25/2010
Last updated
05/25/2010
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