| Organization Name: | FAIRBURY CLINIC, P.C. |
| NPI Number: | 1619948551 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | JACKI MOELLENBERNDT (OFFICE MANAGER) |
| Mailing Address: | 825 22nd St Fairbury |
| State: | NE US |
| Postal Code: | 683521299 |
| Phone Number: | 4027293361 |
| Fax Number: | 4027294010 |
| NPI Enumeration Date: | 01/30/2006 |
| NPI Last Update Date: | 10/12/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QR1300X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Rural Health |
| Taxonomy Definition: | |