Individual
KELSEY N FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AUD
Contact information
Practice address
1101 9TH ST N, VIRGINIA, MN 55792-2329
(218) 305-0000
Mailing address
400 E 3RD ST, DULUTH, MN 55805-1951
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
528649
MN
Other
Enumeration date
07/03/2024
Last updated
09/10/2024
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