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General NPI Number Information
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NPI Number | 1780069476
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Entity Type | Individual
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Provider Name | EDITH ARELI FAIRCHILD PT
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Gender | Female
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Dates
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Enumeration Date | 07/23/2015
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Last Update Date | 03/31/2022
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Provider Practice Location Address
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Address Line | 804 W JOHNSON AVE
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City | SPRINGDALE
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State | AR
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Zip | 72764-4159
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Country | US
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Telephone | 479-226-2725
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Fax |
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Provider Business Mailing Address
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Address Line | 1305 SYCAMORE ST
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City | CAVE SPRINGS
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State | AR
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Zip | 72718-7008
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Country | US
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Telephone | 479-226-2725
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2251P0200X
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Taxonomy Name | Pediatric Physical Therapist
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License Number |
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License Number State |
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