Individual
JARED FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPT
Contact information
Practice address
1577 W 7000 S, #100, WEST JORDAN, UT 84084-7492
(801) 566-6301
Mailing address
9720 S 1300 E, #W200, SANDY, UT 84094-3712
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
9634569-2401
UT
Other
Enumeration date
02/19/2016
Last updated
02/19/2016
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