Individual
CAROL FAIRCHILD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA, ATC
Contact information
Practice address
201 KIMBERLY LN, WILLIAMSTOWN, KY 41097-9458
(859) 824-7803
Mailing address
1811 WHISPERING TRL, UNION, KY 41091-9539
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A03092
KY
2255A2300X
Athletic Trainer
089502532
KY
Other
Enumeration date
01/08/2007
Last updated
08/18/2014
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