Provider Demographics
NPI:1003241514
Name:FISHER, ALICIA J (PT DPT)
Entity Type:Individual
Prefix:
First Name:ALICIA
Middle Name:J
Last Name:FISHER
Suffix:
Gender:F
Credentials:PT DPT
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Other - First Name:
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Mailing Address - Street 1:2001 WESTOWN PKWY
Mailing Address - Street 2:SUITE 107
Mailing Address - City:WEST DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50265-1540
Mailing Address - Country:US
Mailing Address - Phone:515-440-3439
Mailing Address - Fax:515-440-3832
Practice Address - Street 1:516 NILE KINNICK DR S
Practice Address - Street 2:SUITE B
Practice Address - City:ADEL
Practice Address - State:IA
Practice Address - Zip Code:50003-2076
Practice Address - Country:US
Practice Address - Phone:515-993-5599
Practice Address - Fax:515-993-1964
Is Sole Proprietor?:No
Enumeration Date:2013-09-04
Last Update Date:2013-09-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IA005183225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist