Individual
MRS. SARA MICHELE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
515 N MAIN ST, AVILLA, IN 46710-9601
(260) 897-2841
Mailing address
6230 HATHAWAY RD, FORT WAYNE, IN 46818-9545
(260) 615-4437
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
31002824A
IN
Other
Enumeration date
05/21/2012
Last updated
04/12/2024
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