Fish Chiropractic, LLC
Organization Active NPI Chiropractor · Hudson, IA
NPI 1003091828 · NPPES record last updated Dec 31, 2007
Key facts
- NPI
- 1003091828
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Chiropractor 111N00000X
- License
- 06758 (IA)
- Legal business name
- FISH CHIROPRACTIC, LLC
- Practice address
- 505 Washington St
Hudson, IA 50643-2202 - Phone
- (319) 988-9889
- Fax
- (319) 988-9292
- NPI assigned
- Dec 31, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Marci J Fish, D.C.
- Title
- Doctor of Chiropractic
- Phone
- (319) 988-9889
Practitioners 1
-
Marci J Fish, DC
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20050901000789 | IA | Part B Supplier - Clinic/Group Practice | 4880626571 |
Receives reassigned benefits from 1 practitioner Practice locations: Hudson, IA |
National Provider Directory
Locations
100 Eddystone Dr
Hudson, IA 50643
Phone (319) 988-9889
505 Washington St
Hudson, IA 50643
Phone (319) 988-9889
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Chiropractor |
111N00000X | 06758 | IA | Yes |
Addresses
Primary practice location
505 Washington St
Hudson, IA 50643-2202
Mailing address
PO Box 177
Hudson, IA 50643-0177
Phone (319) 988-9889
Other providers in Hudson, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 31, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.