Most Relevant Information
Provider Data
| NPI Number: | 1003515198 |
| Provider Name: | MADISON FISHER |
| Entity Type: | Individual |
| Taxonomy Code: | 390200000X |
| Specialty: | Student in an Organized Health Care Education/Training Program |
| License Number: |
Most Important Dates
| Enumeration Date: | 02/27/2023 |
| Last Updated: | 02/27/2023 |
Provider Practice Location
27 S MARIO CAPECCHI DR
SALT LAKE CITY
UT
841125888
Practice Location Phone/Fax
| Phone: | 8015817498 |
| Fax: |
Provider Mailing Location
27 S MARIO CAPECCHI DR
SALT LAKE CITY
UT
841125888
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |