Individual
KAITLIN MARY FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT, DPT, LAT, ATC
Contact information
Practice address
4400 VESTAL PKWY E, BINGHAMTON, NY 13902-4400
(607) 777-7011
Mailing address
360 VINE ST, LARKSVILLE, PA 18651-1804
(570) 690-4757
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
PT028351
PA
2255A2300X
Athletic Trainer
Primary
004955
NY
2255A2300X
Athletic Trainer
RT008198
PA
Other
Enumeration date
05/22/2020
Last updated
07/29/2025
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