Individual
TINA FULCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
COTA/L
Contact information
Practice address
350 KINGS WAY RD, MARTINSVILLE, VA 24112-6631
(276) 634-1000
Mailing address
571 KEN LANE, RIDGEWAY, VA 24148
(276) 734-0102
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
0131-002102
VA
Other
Enumeration date
04/11/2024
Last updated
04/11/2024
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