Individual
DR. KIM KEVIN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
106 WIMBLEDON SQ, CHESAPEAKE, VA 23320-4931
(757) 436-1037
(757) 547-4031
Mailing address
449 BROAD BEND CIR, CHESAPEAKE, VA 23320-9292
(757) 436-3473
Taxonomy
Speciality
Code
Description
License number
State
111NS0005X
Sports Physician Chiropractor
Primary
0104000403
VA
Other
Enumeration date
08/06/2006
Last updated
11/21/2012
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