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Individual

EDWARD A FULGHUM

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PTA

Contact information

Practice address
509 N BRIGHTLEAF BLVD, SMITHFIELD, NC 27577-4407
(919) 934-8171
Mailing address
1209 PEELE RD, CLAYTON, NC 27520-6863
(252) 292-2816

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5326
NC

Other

Enumeration date
08/08/2018
Last updated
08/08/2018
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