Healthcare Provider Details

I. General information

NPI: 1114842911
Provider Name (Legal Business Name): LINDSEY ANNE FISK
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2026
Last Update Date: 08/11/2026
Certification Date: 08/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

709 W SUPERIOR ST
WAYLAND MI
49348-1226
US

IV. Provider business mailing address

709 W SUPERIOR ST
WAYLAND MI
49348-1226
US

V. Phone/Fax

Practice location:
  • Phone: 269-792-4440
  • Fax:
Mailing address:
  • Phone: 269-792-4440
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: