Individual
RYAN L FULCER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
9000 W WISCONSIN AVE, MILWAUKEE, WI 53226-4874
(414) 266-2625
(414) 262-2635
Mailing address
10000 W INNOVATION DR, SUITE 300, MILWAUKEE, WI 53226-4837
(414) 456-5006
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2566
WI
Other
Enumeration date
06/06/2010
Last updated
06/06/2010
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