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Individual

GARRY T FULLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.C.

Contact information

Practice address
515 N GREEN ST, SUITE 100, BROWNSBURG, IN 46112-2421
(317) 852-8885
(317) 852-7492
Mailing address
515 N GREEN ST, SUITE 100, BROWNSBURG, IN 46112-2421
(317) 852-8885
(317) 852-7492

Taxonomy

Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
08001100
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100133800A
IN
Enumeration date
01/09/2006
Last updated
03/11/2015
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