Individual
PAIGE FISHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
401 VENTURE DR, SOUTH DAYTONA, FL 32119-3478
(386) 763-0084
Mailing address
1200 LEXINGTON GREEN LN, SANFORD, FL 32771-1013
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA 25987
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
686675
MEDICARE
FL
Enumeration date
08/24/2015
Last updated
08/24/2015
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