Individual
ANNA FAIRRIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
714 W GROVE ST, EL DORADO, AR 71730-4416
(870) 863-8194
Mailing address
714 W GROVE ST, EL DORADO, AR 71730-4416
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT4562
AR
Other
Enumeration date
06/16/2020
Last updated
06/16/2020
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