Individual
JIREQUEZ FAIR-HARRIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
4436 CLOVERHILL TER APT 3D, CINCINNATI, OH 45238-6134
(614) 928-7293
Mailing address
4436 CLOVERHILL TER APT 3D, CINCINNATI, OH 45238-6134
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
OH
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2016
Last updated
06/22/2016
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