Provider Demographics
NPI:1508995937
Name:FISHER, STACEY (PT, DPT, CLT-LANA W)
Entity type:Individual
Prefix:DR
First Name:STACEY
Middle Name:
Last Name:FISHER
Suffix:
Gender:F
Credentials:PT, DPT, CLT-LANA W
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:39 N 5TH ST
Mailing Address - Street 2:
Mailing Address - City:GETTYSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17325-2004
Mailing Address - Country:US
Mailing Address - Phone:410-960-7392
Mailing Address - Fax:
Practice Address - Street 1:1004 LITTLESTOWN PIKE
Practice Address - Street 2:SUITE A3
Practice Address - City:WESTMINSTER
Practice Address - State:MD
Practice Address - Zip Code:21157-3007
Practice Address - Country:US
Practice Address - Phone:410-751-6858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-03-02
Last Update Date:2024-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPT023398225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist