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Individual

FAGAN J FRASER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RRT

Contact information

Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111

Taxonomy

Speciality
Code
Description
License number
State
2278G1100X
General Care Certified Respiratory Therapist
1750
AL
2279G1100X
General Care Registered Respiratory Therapist
Primary
002643
GA

Other

Enumeration date
12/06/2012
Last updated
12/06/2012
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