Individual
MS. GAIL FULSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
2529 RAEFORD RD, FAYETTEVILLE, NC 28305-5098
(757) 270-4785
Mailing address
7111 SAN CARLOS CT, FAYETTEVILLE, NC 28314-5264
(757) 270-4785
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
A5970
NC
225700000X
Massage Therapist
Primary
12489
NC
Other
Enumeration date
09/09/2016
Last updated
03/23/2023
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