Individual
RICHARD SEAN FULMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT, CPT
Contact information
Practice address
20 BRUCE LN, PALM COAST, FL 32137
(386) 986-5125
Mailing address
20 BRUCE LN, PALM COAST, FL 32137-8713
(386) 986-5125
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA59413
FL
Other
Enumeration date
08/19/2013
Last updated
08/19/2013
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