Individual
ETHAN WILLIAM KENNEDY FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, LAT
Contact information
Practice address
44 EDDY ST, NORTH ATTLEBORO, MA 02760-2240
(508) 212-4962
Mailing address
44 EDDY ST, NORTH ATTLEBORO, MA 02760-2240
(508) 212-4962
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
3093
MA
Other
Enumeration date
07/23/2018
Last updated
07/23/2018
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