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Individual
MR. KEITH C. FISHER
Active
Individual
MR. KEITH C. FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, OCS, MTC
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2759-024
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
391-99-7089
TRICARE
WI
05
—
40144000
—
WI
Enumeration date
05/23/2006
Last updated
10/21/2025
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