Doctor Name: | GREGORY ALAN FULLING |
NPI Number: | 1235307000 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MS PT |
License Number: | PT00007816 |
Business Practice Address: | 2142 W Railroad Ave Suite A Shelton, WA - 985847813 |
Business Phone Number: | 3604260175 |
Business Fax Number: | 3604322193 |
Mailing Address: | 2142 W Railroad Ave, Suite A SHELTON |
State: | WA |
Postal Code: | 985847813 |
Phone Number: | 3604260175 |
Fax Number: | 3604322193 |
NPI Enumeration Date: | 02/14/2008 |
NPI Last Update Date: | 02/02/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT00007816 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
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 |