Individual
PHILIP FAIR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
(801) 585-2500
Mailing address
501 S CHIPETA WAY, SALT LAKE CITY, UT 84108-1222
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
05/02/2017
Last updated
05/02/2017
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