Individual
BRAD MICHAEL FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
408 S ADAMS, MANITO, IL 61546
(309) 968-7054
(309) 968-7054
Mailing address
408 S ADAMS, MANITO, IL 61546
(309) 968-7054
(309) 968-7054
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
038009721
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
038009721
—
IL
01
—
09032018
BCBS IL
—
Enumeration date
11/14/2006
Last updated
05/07/2008
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