Individual
MR. EVAN THOMAS FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4 BLAISDELL ST, HAVERHILL, MA 01832-5425
(978) 994-7423
Mailing address
4 BLAISDELL STREET, HAVERHILL, MA 01832-5425
(978) 994-7423
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
09/14/2010
Last updated
09/14/2010
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