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Individual

JASON FAUTHEREE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
607 WILLOW BEND ST, CLEBURNE, TX 76031-0314
(817) 312-9637
Mailing address
607 WILLOW BEND ST, CLEBURNE, TX 76031-0314
(817) 312-9637

Taxonomy

Speciality
Code
Description
License number
State
314000000X
Skilled Nursing Facility
Primary

Other

Enumeration date
08/26/2014
Last updated
08/26/2014
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