Individual
WILLIAM LEE FAIRALL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
SOIDC
Contact information
Practice address
8161 RED COCKADED CT APT 103, WILMINGTON, NC 28411-7186
(443) 521-1778
Mailing address
8161 RED COCKADED CT APT 103, WILMINGTON, NC 28411-7186
(443) 521-1778
Taxonomy
Speciality
Code
Description
License number
State
1710I1002X
Independent Duty Corpsman
Primary
—
—
Other
Enumeration date
02/02/2010
Last updated
02/02/2010
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