Individual
MS. KATHLEEN C FISHE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(570) 645-2131
Mailing address
360 W RUDDLE ST, COALDALE, PA 18218-1027
(570) 645-2131
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA003153L
PA
363AS0400X
Surgical Physician Assistant
MA003153L
PA
Other
Enumeration date
04/30/2007
Last updated
07/31/2007
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