Organization
MARJEANNE R FISHER
Active
Other names
new image breast prosthesis
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARJEANNE ROSE FISHER (OWNER)
(513) 867-1184
Entity
Organization
Contact information
Practice address
765 BEISSINGER RD, HAMILTON, OH 45013-9762
(513) 867-1184
Mailing address
4406 HUSTON RD, HAMILTON, OH 45013-9762
(513) 867-1184
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
RN137249
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0903982
—
OH
Enumeration date
06/08/2006
Last updated
06/18/2008
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