Individual
AARON BRYCE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
COTA
Contact information
Practice address
8008 S JESSE OWENS PKWY, PHOENIX, AZ 85042-6516
(602) 243-2780
(602) 243-7079
Mailing address
4432 E DOUGLAS AVE, GILBERT, AZ 85234-7409
(480) 272-6215
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
5360
AZ
Other
Enumeration date
07/06/2015
Last updated
07/06/2015
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