Individual
BRANDY DAWN FULSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6525 N MERIDIAN AVE STE 311, OKLAHOMA CITY, OK 73116-1410
(405) 721-1115
Mailing address
8331 S TOLEDO AVE, TULSA, OK 74137-1844
(918) 857-0428
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA698
OK
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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