Provider Demographics
NPI:1174558969
Name:FISCHER, JOHN K (PT)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:K
Last Name:FISCHER
Suffix:
Gender:M
Credentials:PT
Other - Prefix:MR
Other - First Name:KENNETH
Other - Middle Name:
Other - Last Name:FISCHER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PT
Mailing Address - Street 1:8788 N MAYA CT
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85742-8662
Mailing Address - Country:US
Mailing Address - Phone:520-579-7286
Mailing Address - Fax:
Practice Address - Street 1:8788 N MAYA CT
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85742-8662
Practice Address - Country:US
Practice Address - Phone:520-579-7286
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-11
Last Update Date:2009-12-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7507225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ1174558969OtherNPI