Individual
JAIMIE FULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
225 1ST AVE NE, OSSEO, MN 55369-1201
(763) 424-0534
Mailing address
8795 HASTINGS CIR NE, BLAINE, MN 55449-4508
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
05/09/2007
Last updated
07/08/2007
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