Individual
MR. TIMOTHY FAHEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
4 NEWFIELD ST, LEICESTER, MA 01524-1416
(508) 954-0943
Mailing address
4 NEWFIELD ST, LEICESTER, MA 01524-1416
(508) 954-0943
Taxonomy
Speciality
Code
Description
License number
State
171000000X
Military Health Care Provider
Primary
6741
MA
Other
Enumeration date
06/03/2008
Last updated
06/03/2008
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