Doctor Name: | STEVE FULLER |
NPI Number: | 1942610985 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | |
License Number: | PT-2424 |
Business Practice Address: | 1014 Burrell Ave Lewiston, ID - 835015589 |
Business Phone Number: | 2087434558 |
Business Fax Number: | 2087467657 |
Mailing Address: | 25117 Sw Parkway Ave Ste D, WILSONVILLE |
State: | OR |
Postal Code: | 970709697 |
Phone Number: | |
Fax Number: | |
NPI Enumeration Date: | 04/29/2014 |
NPI Last Update Date: | 04/29/2014 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 225100000X |
License Number: | PT-2424 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | ID |
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 |