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Individual

KYLE FAIRCHILD

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MS OTR/L

Contact information

Practice address
451 E BISHOP FEDERAL LN, SALT LAKE CITY, UT 84115-2357
(801) 487-7557
Mailing address
877 W 3600 S, BOUNTIFUL, UT 84010-8423
(208) 670-1018

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
9379311-4201
UT

Other

Enumeration date
04/18/2018
Last updated
04/18/2018
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