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General NPI Number Information
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NPI Number | 1396252334
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Entity Type | Individual
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Provider Name | BRIAN THOMAS FISK PHARMD
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Gender | Male
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Dates
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Enumeration Date | 12/29/2017
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Last Update Date | 12/29/2017
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Provider Practice Location Address
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Address Line | 500 37TH ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-3404
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Country | US
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Telephone | 507-289-7408
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Fax | 507-289-9036
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Provider Business Mailing Address
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Address Line | 500 37TH ST NW
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City | ROCHESTER
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State | MN
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Zip | 55901-3404
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Country | US
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Telephone | 507-289-7408
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Fax | 507-289-9036
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | 120386
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License Number State | MN
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