Individual
KURT D FULLMER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
406 E ROWAN AVE, SUITE200, SPOKANE, WA 99207-1243
(509) 489-4040
(509) 489-9190
Mailing address
406 E ROWAN AVE, SUITE200, SPOKANE, WA 99207-1243
(509) 489-4040
(509) 489-9190
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA10002270
WA
Other
Enumeration date
10/27/2006
Last updated
07/08/2007
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