Healthcare Provider Details

I. General information

NPI: 1710212378
Provider Name (Legal Business Name): ASHLEE E FISCHER O.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ASHLEE E MILLS-FISCHER O.D.

II. Dates (important events)

Enumeration Date: 10/14/2009
Last Update Date: 09/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

609 4J CT
GILLETTE WY
82716-4135
US

IV. Provider business mailing address

609 4J CT
GILLETTE WY
82716-4135
US

V. Phone/Fax

Practice location:
  • Phone: 307-682-2020
  • Fax: 307-682-5656
Mailing address:
  • Phone: 307-682-2020
  • Fax: 307-682-5656

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number334T
License Number StateWY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: