| NPI | 1891321030 |
|---|---|
| Former Name | MARY K FAIRCHILD |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 225100000X Physical Therapist (Licence: PA PT029112) |
| Additional Taxonomies | 225100000X Physical Therapist (Licence: NJ 40QA01919400) |
| Enumeration Date | 2020-03-19 |
| Last Update Date | 2025-08-11 |