Individual
DAVID BRANDON FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OTR/L
Contact information
Practice address
5201 LAKELAND BLVD APT 157, FLOWOOD, MS 39232-8919
(601) 562-2164
Mailing address
5201 LAKELAND BLVD APT 157, FLOWOOD, MS 39232-8919
(601) 562-2164
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
OT3047
MS
Other
Enumeration date
06/15/2015
Last updated
06/15/2015
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