Individual
JENNIFER E FISKE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
17300 N OUTER 40 RD, SUITE 205, CHESTERFIELD, MO 63005-1364
(636) 728-1777
(636) 728-1793
Mailing address
443 LYNN HAVEN LN, HAZELWOOD, MO 63042-1808
(314) 395-9303
(314) 395-9301
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2005000503
MO
Other
Enumeration date
03/26/2007
Last updated
11/07/2012
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