Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 226300000X | Kinesiotherapist |
NPI | 1275746620 |
---|---|
Provider Name | Mrs. Catherine Joy Fuller |
First Address | Eight Mile, AL 36613-2820 |
Second Address | Mobile, AL 36608-1523 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2007 |
Last Update Date | 08/07/2007 |