Individual
SEAN PATRICK FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
544 4TH AVE STE 102, FAIRBANKS, AK 99701-4714
(907) 456-5990
Mailing address
773 N CATHERINE ST, SALT LAKE CITY, UT 84116-2003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
164755
AK
Other
Enumeration date
08/25/2020
Last updated
08/25/2020
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