Fairfield Estates, LLC

NPI #1770789778 in Fairfield, Illinois

Provider Information

NPI Number
1770789778
Entity Type
Organization
Organization Name
Fairfield Estates, LLC
Primary Specialty
Point of Service
Enumeration Date
Jun 26, 2007
Last Updated
Jun 24, 2008

Practice Location

Address
315 NORTH MARKET STREET
ZIP Code
62837
Phone
(618) 842-5875

Authorized Official

Name
MR. JOHN HOLTZ
Title
CONTROLLER
Phone
(541) 747-3373

Specialties & Taxonomy Codes

Specialty
Point of Service

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