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Individual

MR. ROBERT FISHBACK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
4521 MESA RICO, LAS CRUCES, NM 88011-7215
(575) 642-6688
Mailing address
4521 MESA RICO, LAS CRUCES, NM 88011
(575) 642-6688

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
13499
NM

Other

Enumeration date
10/09/2009
Last updated
10/09/2009
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