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General NPI Number Information
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NPI Number | 1356542286
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Entity Type | Individual
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Provider Name | KATHERINE SUE FISHER PT
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Gender | Female
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Dates
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Enumeration Date | 05/29/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 921 ALGER ST SE
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City | GRAND RAPIDS
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State | MI
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Zip | 49507-3827
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Country | US
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Telephone | 616-819-7050
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Fax |
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Provider Business Mailing Address
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Address Line | 10831 GRANGE AVE
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City | SPARTA
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State | MI
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Zip | 49345-8342
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Country | US
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Telephone | 616-887-4905
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | L926765
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License Number State | MI
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