Individual
SAMANTHA JO FULLERTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
2218 W 32ND ST, JOPLIN, MO 64804-3514
(417) 623-5264
Mailing address
1808 NEW HAMPSHIRE AVE, JOPLIN, MO 64804-0953
(417) 392-9327
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
115050
TX
225X00000X
Occupational Therapist
Primary
2018009632
MO
Other
Enumeration date
10/15/2012
Last updated
08/05/2025
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