MR. Charles Randolph Fisk, LMP
NPI #1275719494 in Bonney Lake, Washington
Provider Information
- NPI Number
- 1275719494
- Entity Type
- Individual
- Name
- MR. Charles Randolph Fisk, LMP
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Massage Therapist
- Credential
- LMP
- Enumeration Date
- Jan 17, 2008
- Last Updated
- Nov 18, 2010
Practice Location
- Address
- 18124 114TH ST E
- City
- Bonney Lake
- State
- Washington
- ZIP Code
- 98391-5168
- Phone
- (253) 229-5819
Specialties & Taxonomy Codes
| Specialty |
|---|
| Massage Therapist |
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