Doctor Name: | KAITLYN FULLER |
NPI Number: | 1093138158 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | DPT |
License Number: | 036493 |
Business Practice Address: | 1744 W Genesee St Syracuse, NY - 132041902 |
Business Phone Number: | 3154683414 |
Business Fax Number: | |
Mailing Address: | 12 Lock Tenders Dr, JORDAN |
State: | NY |
Postal Code: | 130809741 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 01/27/2014 |
NPI Last Update Date: | 01/27/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | 036493 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Taxonomy Classification: | Physical Therapist |
Taxonomy Specialization: | |
Taxonomy Definition: | (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT |