Individual
FAYOLA O ETIENNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
1145 19TH ST NW STE 403, WASHINGTON, DC 20036-3716
(202) 721-7680
Mailing address
4 HART DR N, SOUTH ORANGE, NJ 07079-1534
(862) 371-8510
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
25408
MA
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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