Individual
BAILEE MARIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
10400 W 103RD ST STE 22, OVERLAND PARK, KS 66214-2664
(913) 322-4000
Mailing address
10400 W 103RD ST, STE 22, OVERLAND PARK, KS 66214-2664
(913) 322-4000
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-03368
KS
225200000X
Physical Therapy Assistant
2018032378
MO
Other
Enumeration date
09/11/2019
Last updated
11/07/2019
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