Jason Michael Fannin

NPI #1740760628 in Wylie, Texas

Provider Information

NPI Number: 1740760628
Entity Type: Individual
Name: Jason Michael Fannin
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Enumeration Date: Aug 20, 2018
Last Updated: Aug 20, 2018

Practice Location

Address: 1420 MCCREARY RD
City: Wylie
State: Texas
ZIP Code: 75098-8776
Phone: (972) 442-6776

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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