Individual
TODD MAXWELL FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
51 PETERS RD, LITITZ, PA 17543-7685
(717) 627-2400
Mailing address
51 PETERS RD, LITITZ, PA 17543-7685
(717) 627-2400
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT001830A
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
950102
NATABOC
—
Enumeration date
12/12/2017
Last updated
12/12/2017
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