Individual
CLARE M FANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT MHS
Contact information
Practice address
3 PARKVIEW CT, NEWTOWN, PA 18940-1186
(267) 474-3105
Mailing address
3 PARKVIEW CT, NEWTOWN, PA 18940-1186
(267) 474-3105
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
40QA00330000
NJ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0
NONE
—
Enumeration date
12/17/2018
Last updated
12/17/2018
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