Individual
KENNETH G FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1465 E PARKDALE AVE, MANISTEE, MI 49660-9709
(231) 398-1000
Mailing address
1465 E PARKDALE AVE, MANISTEE, MI 49660-9709
(231) 398-1000
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
4704208606
MI
Other
Enumeration date
02/19/2007
Last updated
07/09/2007
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