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1760727929
DEREK FAIRROW
MADISONVILLE, KY
NPI
1760727929
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225200000X Physical Therapy Assistant
(Licence: KY A02649)
Enumeration Date
2012-11-29
Last Update Date
2012-11-29
Business Address
-- DEREK FAIRROW PTA
1500 PRIDE AVE
MADISONVILLE, KY 42431-9157
Phone number: 270-821-1813
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Mailing Address
-- DEREK FAIRROW PTA
1500 PRIDE AVE
MADISONVILLE, KY 42431-9157
Phone number: 270-821-1813
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