Organization
3-STEP THERAPY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. THEODIS LAMAR FULMORE JR. (PRESIDENT)
(954) 825-3317
Entity
Organization
Contact information
Practice address
5100 W COPANS RD STE 300, MARGATE, FL 33063-7700
(954) 825-3317
(954) 793-4949
Mailing address
5100 W COPANS RD STE 300, MARGATE, FL 33063-7700
(954) 825-3317
(954) 793-4949
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
116173500
—
FL
Enumeration date
04/07/2021
Last updated
12/12/2022
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