Individual
ADDISON FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4611 33RD ST, LUBBOCK, TX 79410-2414
(806) 786-7131
Mailing address
4611 33RD ST, LUBBOCK, TX 79410-2414
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
123679
TX
Other
Enumeration date
07/12/2023
Last updated
07/12/2023
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