Individual
JASON ROY FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
9313 MEDICAL PLAZA DR STE 306, CHARLESTON, SC 29406-9197
(843) 303-9418
Mailing address
790 REMINGTON BLVD, BOLINGBROOK, IL 60440-4909
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
SC
Other
Enumeration date
10/22/2017
Last updated
10/22/2017
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