Doctor Name: | DR. BRUCE WAYNE FISSETTE |
NPI Number: | 1073535357 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | DC, PHD |
License Number: | DC26387 |
Business Practice Address: | 7020 Trask Ave Westminster, CA - 926832622 |
Business Phone Number: | 9496733154 |
Business Fax Number: | 9497238348 |
Mailing Address: | 1809 W Bay Ave, NEWPORT BEACH |
State: | CA |
Postal Code: | 926634516 |
Phone Number: | 9496733154 |
Fax Number: | 9497238348 |
NPI Enumeration Date: | 07/24/2006 |
NPI Last Update Date: | 07/31/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC26387 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | CA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |