Individual
JOSHUA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
(215) 546-5960
Mailing address
1526 LOMBARD ST, PHILADELPHIA, PA 19146-1625
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE011681
PA
Other
Enumeration date
03/19/2020
Last updated
03/19/2020
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