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NPI Code Detail

MEDICARE: SHELLEY A FISHER LMT

MEDICARE:   SHELLEY A FISHER  LMT
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
1225700000XMassage TherapistMA31558FL

General Provider Information

NPI Number : 1881784197
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHELLEY A FISHER LMT
Provider Business Mailing Address
First Line : PO BOX 699
Second Line :
City : HAINES CITY
State : FL
Zip : 33845-0699
Country : US
Telephone Number : 863-421-9102
Fax Number : 863-422-6233
Provider Business Practice Location Address
First Line : 8316 W LAKE MARION RD
Second Line :
City : HAINES CITY
State : FL
Zip : 33844-8731
Country : US
Telephone Number : 863-206-2874
Fax Number : 863-422-6233
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/15/2006
Last Update Date : 07/08/2007

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Directions to “ SHELLEY A FISHER LMT” Practice Location

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