Individual
DR. MARK B FULLERTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
109 S MAIN ST, WOODRUFF, SC 29388-1849
(864) 476-2200
(864) 476-0757
Mailing address
109 S MAIN ST, WOODRUFF, SC 29388-1849
(864) 476-2200
(864) 476-0757
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1130
SC
111N00000X
Chiropractor
DC-002887-L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
CH1130
—
SC
Enumeration date
01/16/2007
Last updated
11/21/2007
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