Individual
JAMIE FAIRCLOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1711 GENESIS DR, DUBLIN, GA 31021-0595
(478) 246-1040
Mailing address
1711 GENESIS DR, DUBLIN, GA 31021-0595
(478) 697-5881
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/06/2024
Last updated
03/06/2024
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