Individual
DR. MATTHEW RYAN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC, LMT
Contact information
Practice address
4225 LONG BRANCH RD, LIVERPOOL, NY 13090-3201
(315) 515-0111
Mailing address
80 E BAYARD ST, SENECA FALLS, NY 13148-1626
(315) 577-2028
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
013343
NY
Other
Enumeration date
07/28/2021
Last updated
07/28/2021
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