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Organization

FULLER'S ORTHOPEDIC

Active
Parent organization
FULLER'S ORTHOPEDIC
Other names
Independence Prosthetics-Orthotics
Organization subpart
Yes

Provider details

NPI number
Legal business name
FULLER'S ORTHOPEDIC
Authorized official
BRYAN CARROLL FULLER CPO (MANAGER)
(434) 529-8882
Entity
Organization

Contact information

Practice address
36 PARKWAY LN STE 122, FISHERSVILLE, VA 22939-2430
(540) 917-0006
(540) 917-0506
Mailing address
36 PARKWAY LN STE 122, FISHERSVILLE, VA 22939-2430
(540) 917-0006
(540) 917-0506

Taxonomy

Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary

Other

Enumeration date
10/25/2023
Last updated
10/25/2023
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