Doctor Name: | ROBERT EDWARD FULLER |
NPI Number: | 1356545727 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PHYSICAL THERAPIET |
License Number: | PT5659 |
Business Practice Address: | 11234 Anderson St Loma Linda, CA - 923542804 |
Business Phone Number: | 9095584000 |
Business Fax Number: | |
Mailing Address: | 240 Fallbrook Ct, REDLANDS |
State: | CA |
Postal Code: | 923735002 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 06/12/2007 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT5659 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
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 |