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NPI Code Detail

MEDICARE: LUANNA FISHER PTA

MEDICARE: LUANNA FISHER PTA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225200000XPhysical Therapy Assistant4397TN

General Provider Information

NPI Number : 1437817046
Entity Type Code : Individual
Provider Name (Legal Business Name) : LUANNA FISHER PTA
Provider Business Mailing Address
First Line : 1035 WILLIAMS RD
Second Line :
City : HORNBEAK
State : TN
Zip : 38232-3433
Country : US
Telephone Number : 731-446-7447
Fax Number :
Provider Business Practice Location Address
First Line : 1105 S SUNSWEPT ST
Second Line :
City : UNION CITY
State : TN
Zip : 38261-4370
Country : US
Telephone Number : 731-885-6400
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/30/2021
Last Update Date : 12/01/2021

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Directions to “ LUANNA FISHER PTA” Practice Location

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