Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251P0200X | Physical Therapist - Pediatrics | 11-04984 | KS |
N | 2251P0200X | Physical Therapist - Pediatrics | 2014039418 | MO |
NPI | 1124479605 |
---|---|
Provider Name | Rindalyn Fairchild |
First Address | Overland Park, KS 66223-3894 |
Second Address | Overland Park, KS 66211-1630 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/06/2016 |
Last Update Date | 27/06/2016 |