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1942531017
STEVEN FAIRBANK
THOMPSON FALLS, MT
NPI
1942531017
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: MT 407)
Enumeration Date
2010-01-28
Last Update Date
2010-01-28
Business Address
-- STEVEN FAIRBANK LAC, NCAC II
100 GRAVES CREEK RD
THOMPSON FALLS, MT 59873-9400
Phone number: 406-827-9853
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Mailing Address
-- STEVEN FAIRBANK LAC, NCAC II
PO BOX 1310
THOMPSON FALLS, MT 59873-1310
Phone number: 406-827-9853
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