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NPI 1740671015

NPI 1740671015 : NICHOLAS FISCHER LAT, ATC : ASHEVILLE, NC

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General NPI Number Information
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    NPI Number           |    1740671015
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    Entity Type          |    Individual 
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    Provider Name        |    NICHOLAS FISCHER LAT, ATC
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    Gender               |    Male 
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Dates
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    Enumeration Date     |    02/09/2015
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    Last Update Date     |    02/09/2015
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Provider Practice Location Address
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    Address Line         |    534 BILTMORE AVE 
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    City                 |    ASHEVILLE
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    State                |    NC
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    Zip                  |    28801-4612
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    Country              |    US
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    Telephone            |    507-828-8156
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    Fax                  |    828-213-8665
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Provider Business Mailing Address
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    Address Line         |    300 LONG SHOALS RD APT 5U 
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    City                 |    ARDEN
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    State                |    NC
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    Zip                  |    28704-7719
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    Country              |    US
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    Telephone            |    507-828-8156
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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        |    2255A2300X
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    Taxonomy Name        |    Athletic Trainer
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    License Number       |    LAT-2551
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    License Number State |    NC
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