Individual
GARY L FISHER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
2014 N WAYNE ST, TRI STATE CHIROPRACTIC CLINIC PC, ANGOLA, IN 46703-9102
(260) 665-3106
Mailing address
2014 N WAYNE ST, ANGOLA, IN 46703-9102
(260) 665-3106
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08000350
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000240945
ANTHEM BCBS PIN
—
Enumeration date
03/17/2006
Last updated
07/08/2007
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