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1952767212
ADRIENNE J FAIRCLOTH
HYATTSVILLE, MD
NPI
1952767212
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MD A0000784)
Enumeration Date
2016-01-01
Last Update Date
2016-05-17
Business Address
-- ADRIENNE J FAIRCLOTH ATC
4313 MADISON ST
HYATTSVILLE, MD 20781-1625
Phone number: 240-764-2533
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Mailing Address
-- ADRIENNE J FAIRCLOTH ATC
9709 49TH PL
COLLEGE PARK, MD 20740-1433
Phone number: 757-831-5554
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