BRENT R FAIRBANKS

SPRINGFIELD, MO
NPI1538418793
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy367H00000X Anesthesiologist Assistant
(Licence: MO  2012028957)
Enumeration Date2012-09-04
Last Update Date2013-02-22
Business Address
-- BRENT R FAIRBANKS AA
1235 E CHEROKEE
SPRINGFIELD, MO 65804-2203
Phone number: 417-820-2829
Mailing Address
-- BRENT R FAIRBANKS AA
P.O. BOX 2580
SPRINGFIELD, MO 65801-2580
Phone number: 417-829-4620
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