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1780898577
THERESA LANE FISHER
JACKSON, MS
NPI
1780898577
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
363A00000X Physician Assistant
(Licence: MS PA011)
Enumeration Date
2007-05-10
Last Update Date
2012-04-13
Business Address
-- THERESA LANE FISHER P.A.
4436 NORTH STATE STREET, SUITE AI
JACKSON, MS 39206-3073
Phone number: 769-257-5336
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Mailing Address
-- THERESA LANE FISHER P.A.
4436 NORTH STATE STREET, SUITE AI
JACKSON, MS 39206-3073
Phone number: 769-257-5336
Copy
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