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1407055874
SUSAN C FAIR DO PA
MERRITT ISLAND, FL
NPI
1407055874
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Entity Type
Organization
Authorized Contact
SUSAN C FAIR
President
321-455-1226
Organization Subpart ?
No
Primary Taxonomy
207Q00000X Family Medicine
(Licence: FL OS7489)
Enumeration Date
2007-07-16
Last Update Date
2007-09-14
Business Address
SUSAN C FAIR DO PA
595 N COURTENAY PKWY SUITE 102
MERRITT ISLAND, FL 32953-4851
Phone number: 321-455-1226
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Mailing Address
SUSAN C FAIR DO PA
595 N COURTENAY PKWY SUITE 102
MERRITT ISLAND, FL 32953-4851
Phone number: 321-455-1226
Copy
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