Michaela Ashlyn Fairbanks, ATC,LAT
NPI #1144794793 in Deer River, Minnesota
Provider Information
- NPI Number
- 1144794793
- Entity Type
- Individual
- Name
- Michaela Ashlyn Fairbanks, ATC,LAT
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist/Technologist - Athletic Trainer
- Credential
- ATC,LAT
- Enumeration Date
- Jan 16, 2019
- Last Updated
- Apr 7, 2022
Practice Location
- Address
- 44711 COUNTY ROAD 18
- City
- Deer River
- State
- Minnesota
- ZIP Code
- 56636-2148
- Phone
- (218) 368-7931
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist/Technologist - Athletic Trainer — Athletic Trainer |
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