Individual
JEFFREY LAURENCE FAIRLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT, OCS
Contact information
Practice address
224 N INDIAN HILL BLVD, CLAREMONT, CA 91711-4609
(909) 621-0477
Mailing address
4232 LYND AVE, ARCADIA, CA 91006-5834
(626) 821-5434
(626) 821-5434
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
PT25533
CA
2251X0800X
Orthopedic Physical Therapist
PT25533
CA
Other
Enumeration date
09/26/2006
Last updated
09/11/2025
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