Individual
KAYLA RAE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPTA
Contact information
Practice address
1944 CENTERVILLE TPKE STE 101, VIRGINIA BEACH, VA 23464-6839
(757) 271-4585
(833) 627-5148
Mailing address
762 INDEPENDENCE BLVD STE B, VIRGINIA BEACH, VA 23455-6200
(757) 917-5061
(757) 904-1821
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2306606334
VA
Other
Enumeration date
05/18/2023
Last updated
10/29/2024
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