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1053655902
MICHELLE AIDA FANNON
SACRAMENTO, CA
NPI
1053655902
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: CA 27986)
Enumeration Date
2012-11-15
Last Update Date
2012-11-15
Business Address
Dr. MICHELLE AIDA FANNON PT, DPT
2723 T ST
SACRAMENTO, CA 95816-7323
Phone number: 916-612-8624
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Mailing Address
Dr. MICHELLE AIDA FANNON PT, DPT
2723 T ST
SACRAMENTO, CA 95816-7323
Phone number: 916-612-8624
Copy
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