MEDICARE: MR. JOHN K FISCHER P.T.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	225100000X	Physical Therapist	7507	AZ

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1174558969	OTHER	AZ	NPI

General Provider Information

NPI Number	:	1174558969
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. JOHN K FISCHER P.T.

Provider Business Mailing Address
First Line	:	8788 N MAYA CT
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8662
Country	:	US
Telephone Number	:	520-579-7286
Fax Number	:

Provider Business Practice Location Address
First Line	:	8788 N MAYA CT
Second Line	:
City	:	TUCSON
State	:	AZ
Zip	:	85742-8662
Country	:	US
Telephone Number	:	520-579-7286
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/11/2006
Last Update Date	:	12/22/2009

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