Individual
MR. MICHEAL FISK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2413 SAINT ROBERT LN, SAINT CHARLES, MO 63301-1449
(314) 378-6489
Mailing address
2413 SAINT ROBERT LN, SAINT CHARLES, MO 63301-1449
(314) 378-6489
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
2013030673
MO
Other
Enumeration date
04/30/2020
Last updated
04/30/2020
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