Individual
KNASTACIA D FAIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMBT NC #11250
Contact information
Practice address
376 HILLIARD DR, FAYETTEVILLE, NC 28311-2691
(704) 648-1569
Mailing address
376 HILLIARD DR, FAYETTEVILLE, NC 28311-2691
(704) 648-1569
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
11250
NC
Other
Enumeration date
11/08/2022
Last updated
11/08/2022
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