Individual
CHAD FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
5069 OTTERBEIN WAY, MONCLOVA, OH 43542-8500
(419) 878-0550
Mailing address
1802 WHISPERING WAY, PERRYSBURG, OH 43551-6909
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
09553
OH
Other
Enumeration date
07/13/2023
Last updated
07/13/2023
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