Dr. Kim Kevin Fuller
Chiropractic Sports Physician
106 Wimbledon Sq
Chesapeake
, Virginia 23320-4931
Dr. Kim Kevin Fuller
Chiropractic Sports Physician
106 Wimbledon Sq
Chesapeake
, Virginia 23320-4931
(757) 436-3473
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About
Features
Specialties
- Chiropractic Sports Physician
Languages spoken
- English
Location
First Address
- Dr. Kim Kevin Fuller
- 449 Broad Bend Cir
- Chesapeake, VA
- Zip : 23320-9292
- Phone : (757) 436-3473
Second Address
- Dr. Kim Kevin Fuller
- 106 Wimbledon Sq
- Chesapeake, VA
- Zip : 23320-4931
- Fax : (757) 547-4031
- Phone : (757) 436-1037
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 111NS0005X | Chiropractic Sports Physician | 0104000403 | VA |
National Provider Identifier
| NPI | 1063421147 |
|---|---|
| Provider Name | Dr. Kim Kevin Fuller |
| First Address | Chesapeake, VA 23320-9292 |
| Second Address | Chesapeake, VA 23320-4931 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | Yes |
| Is Organization Subpart | N/A |
| Enumeration Date | 06/08/2006 |
| Last Update Date | 21/11/2012 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| T21716 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.