Individual
DR. JASON MICHAEL FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
21 NORTH 4TH STREET, HARRISBURG, PA 17101
(717) 233-3476
(717) 796-2409
Mailing address
463 DELANCEY COURT, MECHANICSBURG, PA 17055
(717) 460-3422
(717) 796-2409
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
009494
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
50058252
CAPITAL BLUE CROSS
PA
01
—
FU1813015
HIGHMARK
PA
Enumeration date
06/29/2006
Last updated
07/08/2007
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