Provider Demographics
NPI:1174305817
Name:LAUREN FISK
Entity type:Organization
Organization Name:LAUREN FISK
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:FALLON
Authorized Official - Middle Name:J
Authorized Official - Last Name:TRIMMINGS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:520-461-4948
Mailing Address - Street 1:1385 E GRAND CANYON DR
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5454
Mailing Address - Country:US
Mailing Address - Phone:225-439-7393
Mailing Address - Fax:
Practice Address - Street 1:855 E WARNER RD STE 100
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-0998
Practice Address - Country:US
Practice Address - Phone:225-439-7393
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-10-17
Last Update Date:2023-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty