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1073086252
SCOTT T FAIRHURST
DYER, IN
NPI
1073086252
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: IN 71008681A)
Enumeration Date
2019-01-10
Last Update Date
2023-03-03
Business Address
SCOTT T FAIRHURST
24 JOLIET ST
DYER, IN 46311-1705
Phone number: 219-865-2141
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Mailing Address
SCOTT T FAIRHURST
PO BOX 781076
DETROIT, MI 48278-1076
Phone number: 317-528-4800
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