Individual
MISS MADISON KAY FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
1532 CALUMET AVE, DYER, IN 46311-1588
(219) 515-4700
Mailing address
12607 PRIMROSE CT, WHEATFIELD, IN 46392
(219) 863-2439
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
06006378A
IN
Other
Enumeration date
08/16/2022
Last updated
08/16/2022
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