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1528380219
SAMANTHA B FAIRCLOTH
PERRY, GA
NPI
1528380219
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
235Z00000X Speech-Language Pathologist,
(Licence: GA PCET001520)
Enumeration Date
2010-02-22
Last Update Date
2010-02-22
Business Address
-- SAMANTHA B FAIRCLOTH
902 NORTHSIDE DR
PERRY, GA 31069-3344
Phone number: 478-987-1610
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Mailing Address
-- SAMANTHA B FAIRCLOTH
902 NORTHSIDE DR
PERRY, GA 31069-3344
Phone number: 478-987-1610
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