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Organization

SCOTT FISHER

Active
Other names
Aktive Orthotics
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SCOTT ALAN FISHER CF, PTA (OWNER)
(607) 433-0829
Entity
Organization

Contact information

Practice address
231 CO. HWY 1, BAINBRIDGE, NY 13733
(607) 433-0829
(607) 433-0829
Mailing address
PO BOX 292, SIDNEY, NY 13838-0292
(607) 433-0829
(607) 433-0829

Taxonomy

Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
C16086
NY
335E00000X
Prosthetic/Orthotic Supplier
C16086
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00256-1
PHYSICAL THERAPY LICENSE
NY
05
01901037
NY
Enumeration date
12/26/2007
Last updated
07/22/2008
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