| Doctor Name: | SHANNON FULLER |
| NPI Number: | 1275947814 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RPT |
| License Number: | PTH7164 |
| Business Practice Address: | 1235 Yancey St Roanoke, AL - 362742141 |
| Business Phone Number: | 3348633535 |
| Business Fax Number: | 3348637276 |
| Mailing Address: | 1514 Owens St, GADSDEN |
| State: | AL |
| Postal Code: | 359044938 |
| Phone Number: | 2565431030 |
| Fax Number: | 2564392830 |
| NPI Enumeration Date: | 06/11/2014 |
| NPI Last Update Date: | 06/11/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PTH7164 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | AL |
| 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 |