Individual
DR. JARED JAY FAIRBANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
1605 1ST ST S, WILLMAR, MN 56201-4234
(320) 235-9060
Mailing address
16134 KILLDEER AVE, CLEAR LAKE, IA 50428-8628
(641) 231-1679
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
3333
MN
Other
Enumeration date
06/03/2013
Last updated
06/03/2013
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