Individual
LANCE FAIRBANKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
785 N KESSLER ST, WICHITA, KS 67203-4828
(316) 559-1940
Mailing address
785 N KESSLER ST, WICHITA, KS 67203-4828
(316) 559-1940
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
08/09/2022
Last updated
08/09/2022
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