Individual
MRS. MALINDA C. FAYARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6017 WASHINGTON AVE, OCEAN SPRINGS, MS 39564-2648
(228) 547-6614
Mailing address
10327 SHADY PINE DR, OCEAN SPRINGS, MS 39565-9325
(228) 547-6614
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
PT3173
MS
Other
Enumeration date
12/05/2018
Last updated
12/05/2018
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