Doctor Name: | DR. MARK B FULLERTON |
NPI Number: | 1336290261 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.C. |
License Number: | DC-002887-L |
Business Practice Address: | 109 S Main St Woodruff, SC - 293881849 |
Business Phone Number: | 8644762200 |
Business Fax Number: | 8644760757 |
Mailing Address: | 109 S Main St, WOODRUFF |
State: | SC |
Postal Code: | 293881849 |
Phone Number: | 8644762200 |
Fax Number: | 8644760757 |
NPI Enumeration Date: | 01/16/2007 |
NPI Last Update Date: | 11/21/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 111N00000X |
License Number: | DC-002887-L |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | PA |
Taxonomy Type: | Chiropractic Providers |
Taxonomy Classification: | Chiropractor |
Taxonomy Specialization: | |
Taxonomy Definition: | A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems. |