Individual
JARED WHITFORD FULCHER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
2600 OLD CHERRY POINT RD, NEW BERN, NC 28560-6778
(252) 637-4730
Mailing address
1690 CORE POINT RD, ERNUL, NC 28527-9503
(252) 229-9596
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A6254
NC
Other
Enumeration date
08/30/2018
Last updated
08/30/2018
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