Individual
AMY L FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
739 CHAPPELL DR, RALEIGH, NC 27606-3215
(919) 832-3909
(919) 863-2021
Mailing address
739 CHAPPELL DR, RALEIGH, NC 27606-3215
(919) 832-3909
(919) 863-2021
Taxonomy
Speciality
Code
Description
License number
State
2251P0200X
Pediatric Physical Therapist
Primary
9342
NC
Other
Enumeration date
04/29/2008
Last updated
04/29/2008
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