Fisher, Keith C.

Fisher, Keith C. is an individual health care provider with primary practice located at 1212 Memorial Dr Suite 1, Manitowoc WI 54220-2247. He recently has only one registered license in Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist, which is considered as his primary health care specialty. Fisher, Keith C. can be contacted via phone (920) 652-9554.

Contact Information

Primary practice address
1212 Memorial Dr Suite 1 Manitowoc WI 54220-2247
Phone: (920) 652-9554
Fax: (920) 652-9556
Website:
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Health care specialties

SpecialtyCodeLicense #State
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 2759-024 Wisconsin

Profile Details

NPI number 1124073929
LBN Legal business name Fisher, Keith C.
Credentials PT, OCS, MTC
Entity Individual
Sole proprietor 1 No
Enumeration date May 23rd, 2006
Last updated Nov 11th, 2014 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124073929 NPPES
Wisconsin Other 391-99-7089 TRICARE
Wisconsin MEDICAID 40144000 TRICARE

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