Individual
WILLIAM SHANE FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
PO BOX 30354, FLAGSTAFF, AZ 86003-0354
(928) 266-6493
Mailing address
PO BOX 30354, FLAGSTAFF, AZ 86003-0354
(928) 635-6750
Taxonomy
Speciality
Code
Description
License number
State
311ZA0620X
Adult Care Home Facility
Primary
AL8133H
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
283460
—
AZ
Enumeration date
10/01/2014
Last updated
03/17/2026
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