Individual
NANCY D FULFER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
55 HUMPHREYS CENTER DR, SUITE 200 THE PAIN CLINIC PHYSICAL THERAPY, MEMPHIS, TN 38120-2366
(901) 747-0040
Mailing address
PO BOX 1000, DEPT 441 THE PAIN CLINIC PHYSICAL THERAPY, MEMPHIS, TN 38148-0441
(901) 747-0040
(901) 747-4340
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT0000000446
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3658435
—
TN
01
—
4061923
BLUE CROSS TN
TN
Enumeration date
11/17/2006
Last updated
07/09/2007
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