Individual
DR. THOMAS OWEN FULLMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
1652 S HIGHWAY 165, PROVIDENCE, UT 84332-6701
(435) 752-5522
(435) 752-3075
Mailing address
1652 S HIGHWAY 165, PROVIDENCE, UT 84332-6701
(435) 752-5522
(435) 752-3075
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
7563542-1202
UT
Other
Enumeration date
02/09/2010
Last updated
04/18/2024
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