Ryan Fairchild

NPI #1073632154 in Peoria, Illinois

Provider Information

NPI Number: 1073632154
Entity Type: Individual
Name: Ryan Fairchild
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Mar 28, 2007
Last Updated: Mar 25, 2010

Practice Location

Address: 900 MAIN ST
Address 2: STE 450
City: Peoria
State: Illinois
ZIP Code: 61602-1005
Phone: (309) 672-4568

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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