| Doctor Name: | MISS LIZA DANIELLE FULTZ |
| NPI Number: | 1295856730 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | DPT |
| License Number: | PT21589 |
| Business Practice Address: | 16201 Bass Rd 200 Fort Myers, FL - 339089627 |
| Business Phone Number: | 2394323244 |
| Business Fax Number: | |
| Mailing Address: | 13250 Broadhurst Loop, FORT MYERS |
| State: | FL |
| Postal Code: | 339198114 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 04/03/2007 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 225100000X |
| License Number: | PT21589 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | FL |
| 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 |