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Individual

MR. THOMAS CHARLES FISH JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LPTA

Contact information

Practice address
3150 BURKE MILL RD, WINSTON SALEM, NC 27103-6431
(336) 765-5115
Mailing address
3150 BURKE MILL RD, WINSTON SALEM, NC 27103-6431
(336) 765-5115

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A5008
NC

Other

Enumeration date
01/28/2013
Last updated
01/28/2013
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