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Individual
JENNA M FULMER
Active
Individual
JENNA M FULMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
23777
MD
225100000X
Physical Therapist
Primary
PT021799
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
102781395
—
PA
Enumeration date
07/29/2012
Last updated
12/11/2018
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