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MR. ROGER FAIR CLEM CCC-A

>> Audiologist >> Speech, Language and Hearing Service Providers

Registrant NPI Number: 1457481491

Individual Registrant:
MR. ROGER FAIR CLEM CCC-A
Gender: M
Sole Proprietor

Location and contact information for practice:
140 BATTLEWOOD DR  FORT OGLETHORPE, GA 30742-4006 US
Tel: 706-861-7070  Fax: --

Contact information for business:
1606 LAKE MARINA DR  HIXSON, TN 37343-4661 US
Tel: 423-877-5570  Fax: --

Registration Information:
NPI: 1457481491
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y231H00000XSpeech, Language and Hearing Service Providers
Audiologist
GA3510

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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