Individual
MICHAEL FULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LAT, ATC
Contact information
Practice address
6510 HINSON ST, LAS VEGAS, NV 89118-4413
(702) 499-7237
Mailing address
7340 RED CINDER ST, LAS VEGAS, NV 89131-3320
(702) 499-7237
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
0506322
NV
Other
Enumeration date
08/13/2014
Last updated
08/13/2014
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