KENT ALAN FAIR

MOUNT VERNON, IL
NPI1952321879
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy367500000X Nurse Anesthetist, Certified Registered
(Licence: IL  209-000375)
Enumeration Date2006-07-21
Last Update Date2007-07-08
Business Address
Mr. KENT ALAN FAIR CRNA
1011 WILSHIRE DR
MOUNT VERNON, IL 62864-2743
Phone number: 618-242-4150
Mailing Address
Mr. KENT ALAN FAIR CRNA
1011 WILSHIRE DR
MOUNT VERNON, IL 62864-2743
Phone number: 618-242-4150
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