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NPI Code Detail

MEDICARE: JENNIFER FISK

MEDICARE: JENNIFER FISK
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
1235Z00000XSpeech-Language PathologistSLP005551GA

General Provider Information

NPI Number : 1275678120
Entity Type Code : Individual
Provider Name (Legal Business Name) : JENNIFER FISK
Provider Business Mailing Address
First Line : PO BOX 6327
Second Line :
City : COLUMBUS
State : GA
Zip : 31917-6327
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2515 DOUBLE CHURCHES RD
Second Line :
City : COLUMBUS
State : GA
Zip : 31909-2742
Country : US
Telephone Number : 706-660-8336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/20/2007
Last Update Date : 07/08/2007

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Directions to “ JENNIFER FISK ” Practice Location

Language Start Address Practice Location
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