Individual
BRUCE ROBERT FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
1400 E CROOKED LAKE DR, EUSTIS, FL 32726-5716
(740) 416-2500
Mailing address
1400 E CROOKED LAKE DR, PO BOX 385, EUSTIS, FL 32727
(740) 416-2500
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131000967
VA
224Z00000X
Occupational Therapy Assistant
A01886
MD
224Z00000X
Occupational Therapy Assistant
C1826
WV
224Z00000X
Occupational Therapy Assistant
OTA 11284
FL
Other
Enumeration date
02/07/2012
Last updated
02/07/2012
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