Provider Demographics
NPI:1902873847
Name:FISCHER, RON D (PT/ATC)
Entity Type:Individual
Prefix:MR
First Name:RON
Middle Name:D
Last Name:FISCHER
Suffix:
Gender:M
Credentials:PT/ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21440 S LAKE GEORGE DR NW
Mailing Address - Street 2:
Mailing Address - City:CEDAR
Mailing Address - State:MN
Mailing Address - Zip Code:55011-9225
Mailing Address - Country:US
Mailing Address - Phone:612-799-4137
Mailing Address - Fax:
Practice Address - Street 1:23168 SAINT FRANCIS BLVD NW
Practice Address - Street 2:SUITE 300 ST. FRANCIS NOVACARE REHABILIATION
Practice Address - City:ST FRANCIS
Practice Address - State:MN
Practice Address - Zip Code:55070-9805
Practice Address - Country:US
Practice Address - Phone:763-753-9301
Practice Address - Fax:763-753-9305
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN4505225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist