Organization
FULLMER CHIROPRACTIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THOMAS OWEN FULLMER D.C. (OWNER)
(435) 752-5522
Entity
Organization
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
03/31/2010
Last updated
03/31/2010
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