Individual
KATIE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PAC
Contact information
Practice address
810 VALLEY VIEW BLVD, ALTOONA, PA 16602-6342
(814) 946-5469
Mailing address
810 VALLEY VIEW BLVD, ALTOONA, PA 16602-6342
(814) 946-5469
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA057654
PA
363A00000X
Physician Assistant
OA003572
PA
Other
Enumeration date
10/07/2015
Last updated
12/11/2015
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