Individual
MRS. ANNA MARIE FAIRCLOTH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
552 FRED WEBB RD, MOULTRIE, GA 31768-0581
(229) 985-0440
(229) 890-6868
Mailing address
552 FRED WEBB RD, MOULTRIE, GA 31768-0581
(229) 985-0440
(229) 890-6868
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT001485
GA
Other
Enumeration date
08/22/2005
Last updated
07/08/2007
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