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Individual

MS. JANICE RENEE FAUGHT

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
IDMT

Contact information

Practice address
57950 LEAVENWORTH ST BLDG 250, MCCONNELL AFB, KS 67221-3506
(316) 759-5022
Mailing address
2243 IRONWOOD CT, DERBY, KS 67037-3150
(316) 789-5872

Taxonomy

Speciality
Code
Description
License number
State
1710I1003X
Independent Duty Medical Technicians
Primary

Other

Enumeration date
06/24/2009
Last updated
06/24/2009
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