Individual
GINA MARIE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
540 MELONIE LN, GARDENDALE, AL 35071-2231
(334) 648-6110
Mailing address
540 MELONIE LN, GARDENDALE, AL 35071-2231
(334) 648-6110
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
1593
AL
Other
Enumeration date
01/04/2022
Last updated
01/04/2022
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