Individual
BETTE JO FAIRCLOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
633 VETERANS BLVD, REDWOOD CITY, CA 94063-1408
(650) 363-5658
Mailing address
3151 MELENDY DR, SAN CARLOS, CA 94070-3508
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5181
CA
Other
Enumeration date
04/28/2008
Last updated
04/28/2008
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