Individual
DONALD V FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PHD, ATC, LAT
Contact information
Practice address
310 COLLEGE ST, BARBOURVILLE, KY 40906-1499
(606) 546-1509
Mailing address
310 COLLEGE ST, BARBOURVILLE, KY 40906-1499
(678) 221-7963
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1608
KY
Other
Enumeration date
11/09/2020
Last updated
11/09/2020
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