Individual
MAE GERALYN FAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
P.T.A.
Contact information
Practice address
602 TOURNAMENT DR, AVON LAKE, OH 44012-2284
(216) 534-5599
Mailing address
6175 GIFFORD DR, BROOKLYN, OH 44144-3461
(216) 534-5596
(216) 398-8166
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
00978
OH
Other
Enumeration date
08/08/2009
Last updated
08/08/2009
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