Individual
JESSICA FAIRBAIRN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1745 W HUNT HWY # B103, SAN TAN VLY, AZ 85143-5215
(480) 568-4580
Mailing address
4259 E OAKLAND ST, GILBERT, AZ 85295-6120
(815) 690-7913
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-30100
AZ
Other
Enumeration date
07/17/2018
Last updated
07/17/2018
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