| Organization Name: | BLUE MOUNTAIN MEDICINE |
| NPI Number: | 1245669662 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | ANTHONY LEE FISHER (OWNER) |
| Mailing Address: | 150 S Caldwell St Brevard |
| State: | NC US |
| Postal Code: | 287123602 |
| Phone Number: | 8288834040 |
| Fax Number: | 8288834060 |
| NPI Enumeration Date: | 11/06/2013 |
| NPI Last Update Date: | 01/06/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 208D00000X |
| License Number: | 9701350 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NC |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | General Practice |
| Taxonomy Specialization: | |
| Taxonomy Definition: | |