Individual
ETHAN SCOTT FISHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
L.A.C.
Contact information
Practice address
1448 E CENTER ST, SUITE D, POCATELLO, ID 83201-4132
(208) 232-2986
Mailing address
1448 E CENTER ST, SUITE D, POCATELLO, ID 83201-4132
(208) 232-2986
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
ACU-180
ID
Other
Enumeration date
05/05/2008
Last updated
05/05/2008
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