Individual
CHADWICK ALDEN FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
6051 W EMERALD STREET, BOISE, ID 83704
(208) 302-5150
(208) 302-5155
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642
(208) 302-5150
(208) 302-5155
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
01567
MA
363A00000X
Physician Assistant
Primary
PA-1592
ID
363A00000X
Physician Assistant
PA3909
MA
Other
Enumeration date
10/13/2005
Last updated
03/29/2018
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