Individual
LOREN FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
307 N CASTLEMAN ST, OAK GROVE, LA 71263-8894
(318) 428-3948
Mailing address
4109 HIGHWAY 98 W, SUMMIT, MS 39666-9132
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
OTA.200315
LA
Other
Enumeration date
09/18/2012
Last updated
09/18/2012
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