Individual
DALE DEBRA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NLMT
Contact information
Practice address
2161 SARAH CT, EAST STROUDSBURG, PA 18301
(570) 406-1975
(570) 406-1975
Mailing address
2161 SARAH CT, EAST STROUDSBURG, PA 18301-7933
(570) 406-1975
(570) 406-1975
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
MSG003284
PA
Other
Enumeration date
04/08/2010
Last updated
06/24/2014
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