Healthcare Provider Details

I. General information

NPI: 1093367401
Provider Name (Legal Business Name): SAMUEL CLIFFORD FISCHER PT, DPT, RMSK
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2019
Last Update Date: 10/15/2025
Certification Date: 10/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3708 BROADWAY AVE N STE 110
ROCHESTER MN
55906-4159
US

IV. Provider business mailing address

PO BOX 7197
ROCHESTER MN
55903-7197
US

V. Phone/Fax

Practice location:
  • Phone: 507-322-3460
  • Fax: 507-322-3450
Mailing address:
  • Phone: 507-322-3460
  • Fax: 507-322-3450

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number11509
License Number StateMN
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number11509
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: