Individual
DR. BRYAN L FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
4665 E CACTUS RD, PHOENIX, AZ 85032-7703
(602) 953-3850
(602) 953-9257
Mailing address
4665 E CACTUS RD, PHOENIX, AZ 85032-7703
(602) 953-3850
(602) 953-9257
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1020
AZ
Other
Enumeration date
05/04/2006
Last updated
07/08/2007
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