Individual
KIMBERLY ALLYSON FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA
Contact information
Practice address
427 MARGARET ST, PLATTSBURGH, NY 12901-1707
(518) 561-3803
Mailing address
684 STATE ROUTE 22B, PERU, NY 12972-5416
(518) 593-7327
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
006469-1
NY
Other
Enumeration date
07/16/2009
Last updated
07/16/2009
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