Organization
FULLER PHYSICAL THERAPY
Active
Organization
FULLER PHYSICAL THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAVID CHRISTOPHER FULLER PT,DPT (OWNER AND PHYSICAL THERAPIST)
(270) 256-2932
Entity
Organization
Contact information
Practice address
227 S MAIN ST, BEAVER DAM, KY 42320-2131
(270) 274-9221
(270) 955-2003
Mailing address
PO BOX 445, HARTFORD, KY 42347-0445
(270) 274-9221
(270) 955-2003
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
—
—
225X00000X
Occupational Therapist
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100316910
—
KY
Enumeration date
01/05/2011
Last updated
07/28/2020
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