Individual
DR. KENNETH JOHN FISH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
937 RUSSELL AVE STE B, GAITHERSBURG, MD 20879-3280
(301) 519-1881
(301) 519-1131
Mailing address
PO BOX 2004, MONTGOMERY VILLAGE, MD 20886-2004
(301) 519-1881
(301) 519-1131
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
01987
MD
Other
Enumeration date
03/03/2007
Last updated
07/08/2007
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