Provider Demographics
NPI:1831649680
Name:FISCHER, ADAM SIMPSON (PT, DPT)
Entity Type:Individual
Prefix:DR
First Name:ADAM
Middle Name:SIMPSON
Last Name:FISCHER
Suffix:
Gender:M
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 E SHORE DR
Mailing Address - Street 2:
Mailing Address - City:CULVER
Mailing Address - State:IN
Mailing Address - Zip Code:46511-9120
Mailing Address - Country:US
Mailing Address - Phone:773-580-5064
Mailing Address - Fax:
Practice Address - Street 1:950 E SHORE DR
Practice Address - Street 2:
Practice Address - City:CULVER
Practice Address - State:IN
Practice Address - Zip Code:46511-9120
Practice Address - Country:US
Practice Address - Phone:773-580-5064
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-05
Last Update Date:2016-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY006646225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist