Individual
MRS. KELLY FULP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T.
Contact information
Practice address
701 REVOLUTION ST, HAVRE DE GRACE, MD 21078-3321
(410) 939-4334
Mailing address
352 AMBLESIDE LN, ABERDEEN, MD 21001-1849
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17390
MD
Other
Enumeration date
06/25/2006
Last updated
07/08/2007
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