Provider Demographics
NPI:1760286298
Name:FISHER, BENJAMIN C (PT)
Entity type:Individual
Prefix:DR
First Name:BENJAMIN
Middle Name:C
Last Name:FISHER
Suffix:
Gender:
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:314 COUNTY SEAT DR
Mailing Address - Street 2:
Mailing Address - City:HILLSBOROUGH
Mailing Address - State:NC
Mailing Address - Zip Code:27278-9322
Mailing Address - Country:US
Mailing Address - Phone:919-452-0745
Mailing Address - Fax:
Practice Address - Street 1:50 LIFESTYLE PL STE 3
Practice Address - Street 2:
Practice Address - City:PITTSBORO
Practice Address - State:NC
Practice Address - Zip Code:27312-4982
Practice Address - Country:US
Practice Address - Phone:984-282-3730
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-03
Last Update Date:2025-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC14059225100000X
NCP14059225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist