| NPI | 1063798395 |
|---|---|
| Doing Business As | FAIRBORN FAMILY PRACTICE |
| Entity Type | Organization |
| Authorized Contact | DANIEL D HAIBACH Director Business Development 937-558-3222 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Enumeration Date | 2011-11-01 |
| Last Update Date | 2012-03-08 |