Individual
GREGORY ALAN FULLING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MS PT
Contact information
Practice address
2142 W RAILROAD AVE, SUITE A, SHELTON, WA 98584-7813
(360) 426-0175
(360) 432-2193
Mailing address
2142 W RAILROAD AVE, SUITE A, SHELTON, WA 98584-7813
(360) 426-0175
(360) 432-2193
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT00007816
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8347130
—
WA
Enumeration date
02/14/2008
Last updated
02/02/2015
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