Individual
MINO FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1760 SW 3RD ST, CORVALLIS, OR 97333-1725
(720) 323-8971
Mailing address
1760 SW 3RD ST, CORVALLIS, OR 97333-1725
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
—
—
Other
Enumeration date
03/12/2020
Last updated
03/12/2020
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