Organization
FAIRWAY MANAGEMENT, LLC
Active
Other names
inDeed Wellness
Organization subpart
No
Provider details
NPI number
Authorized official
ROBERT EUGENE BAILEY MD (MEDICAL DIRECTOR)
(315) 682-0325
Entity
Organization
Contact information
Practice address
240 W SENECA ST, SUITE 8, MANLIUS, NY 13104-3401
(315) 682-0328
(315) 682-0295
Mailing address
240 W SENECA ST, SUITE 8, MANLIUS, NY 13104-3401
(315) 682-0328
(315) 682-0295
Taxonomy
Speciality
Code
Description
License number
State
291U00000X
Clinical Medical Laboratory
Primary
33D2071872
NY
Other
Enumeration date
08/05/2014
Last updated
08/05/2014
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