Individual
KYLE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
619 19TH ST S, BIRMINGHAM, AL 35233-1900
(205) 934-4011
Mailing address
5301 PINECREST DR, MOUNT OLIVE, AL 35117-3335
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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