Lance Fairbanks

NPI #1619605599 in Wichita, Kansas

Provider Information

NPI Number: 1619605599
Entity Type: Individual
Name: Lance Fairbanks
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Technician, Other
Enumeration Date: Aug 9, 2022
Last Updated: Aug 9, 2022

Practice Location

Address: 785 N KESSLER ST
City: Wichita
State: Kansas
ZIP Code: 67203-4828
Phone: (316) 559-1940

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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