Individual
DONNA MARIE FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
703 E MAPLE AVE, NEWARK, NY 14513-1845
(315) 331-1700
(315) 331-3946
Mailing address
224 SCOTT LN, HORSEHEADS, NY 14845-1956
(607) 739-4377
Taxonomy
Speciality
Code
Description
License number
State
133N00000X
Nutritionist
Primary
0041591
NY
Other
Enumeration date
03/26/2007
Last updated
07/08/2007
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