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General NPI Number Information
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NPI Number | 1588248041
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Entity Type | Individual
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Provider Name | KAYLA FISCHER LAT, ATC
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Gender | Female
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Dates
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Enumeration Date | 05/11/2021
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Last Update Date | 05/11/2021
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Provider Practice Location Address
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Address Line | 825 34TH AVE E APT 201
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2918
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Country | US
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Telephone | 320-420-6463
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Fax |
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Provider Business Mailing Address
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Address Line | 825 34TH AVE E APT 201
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City | ALEXANDRIA
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State | MN
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Zip | 56308-2918
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Country | US
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Telephone | 320-420-6463
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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 | 207XX0005X
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Taxonomy Name | Sports Medicine (Orthopaedic Surgery) Physician
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License Number | 3303
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License Number State | MN
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