Individual
AMBER C. FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
(706) 322-6661
(706) 327-6701
Mailing address
6262 VETERANS PKWY, COLUMBUS, GA 31909-3540
(706) 322-6661
(706) 327-6701
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA002338
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
PTA002338
LICENSE
GA
Enumeration date
04/11/2007
Last updated
07/08/2007
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