Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | S-D13-TA-951 | AL |
NPI | 1013340371 |
---|---|
Provider Name | Dr. Patricia Marie Fulmer |
First Address | Huntsville, AL 35803-5200 |
Second Address | Huntsville, AL 35803-2666 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2013 |
Last Update Date | 06/10/2020 |