MEDICARE: ASHLEY LYNN FISHER PT, DPT

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	9666	MN

General Provider Information

NPI Number	:	1255189031
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ASHLEY LYNN FISHER PT, DPT

Provider Business Mailing Address
First Line	:	2541 223RD LN NW
Second Line	:
City	:	OAK GROVE
State	:	MN
Zip	:	55011-5018
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1545 RIVER HILLS PKWY NW
Second Line	:
City	:	CAMBRIDGE
State	:	MN
Zip	:	55008-3738
Country	:	US
Telephone Number	:	763-689-1474
Fax Number	:

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

Provider Enumeration Date	:	05/08/2024
Last Update Date	:	05/08/2024

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