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Organization
FAIRFAX FAMILY PHYSICAL THERAPY, P.C.
Active
Organization
FAIRFAX FAMILY PHYSICAL THERAPY, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTAL R JENNESS P.T. (PRESIDENT)
(802) 849-9308
Entity
Organization
Contact information
Practice address
1282 MAIN ST, FAIRFAX, VT 05454-9534
(802) 849-9308
Mailing address
1282 MAIN ST, FAIRFAX, VT 05454-9534
(802) 849-9308
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
0400000972
VT
Other
Enumeration date
07/18/2008
Last updated
07/18/2008
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