Individual
EMILY REBECCA FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
190 OUTER MAIN ST, POTSDAM, NY 13676-2324
(315) 265-9271
(315) 265-4206
Mailing address
190 OUTER MAIN ST, POTSDAM, NY 13676-2324
(315) 265-9271
(315) 265-4206
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
014608
NY
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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