Individual
TROY M FULTON
Active
Individual
TROY M FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MPT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT-526
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
115325100
—
WY
01
—
192548
WORK COMP
WA
01
—
315266
BLUE CROSS BLUE SHIELD
WY
Enumeration date
09/29/2006
Last updated
11/08/2016
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