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Robert Fairbanks
NPI 1972146041 · on the registry since 2019 · sole proprietor
Practice
- Address
- 1502 Willard Ave # A
Detroit Lakes, MN 56501 - Phone
- (218) 847-3456
Additional practice sites
- 1038 Campbell Ave, Detroit Lakes, MN
Registry record
- Primary taxonomy
- 343900000X
343900000X
- Licence states on file
- MN
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2022-09-30
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Minnesota