Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111N00000X | Chiropractor | 2613 | NJ |
N | 111N00000X | Chiropractor | 4112 | CO |
N | 111NN1001X | Nutrition | CHIR008084 | GA |
NPI | 1538252101 |
---|---|
Provider Name | Dr. Dale Annette Fairchild |
First Address | Mahwah, NJ 07430 |
Second Address | Waldwick, NJ 07463 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 08/07/2007 |