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Individual
DR. JAY D. FULLINWIDER
Active
Individual
DR. JAY D. FULLINWIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
3647
CO
111NR0400X
Rehabilitation Chiropractor
3647
CO
Other
Enumeration date
04/02/2007
Last updated
05/22/2009
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