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1184645814
JONATHAN T FAIRBANK
BURLINGTON, VT
NPI
1184645814
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
2085N0904X Radiology, Nuclear Radiology
(Licence: VT 042-0003761)
Enumeration Date
2006-07-21
Last Update Date
2007-07-08
Business Address
Dr. JONATHAN T FAIRBANK MD
111 COLCHESTER AVE DEPT. OF RADIOLOGY
BURLINGTON, VT 05401-1473
Phone number: 802-847-3592
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Mailing Address
Dr. JONATHAN T FAIRBANK MD
283 SPEAR ST
CHARLOTTE, VT 05445-9132
Phone number: 802-847-3592
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