Individual
MICHAELA ASHLYN FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC,LAT
Contact information
Practice address
44711 COUNTY ROAD 18, DEER RIVER, MN 56636-2148
(218) 368-7931
Mailing address
44711 COUNTY ROAD 18, DEER RIVER, MN 56636-2148
(218) 368-7931
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
01/16/2019
Last updated
04/07/2022
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