Individual
MADISON EUBANKS FULLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT DPT
Contact information
Practice address
10321 CHAMPION FARMS DR, LOUISVILLE, KY 40241-6129
(502) 882-9379
(502) 805-0529
Mailing address
1650 LYNDON FARM CT STE 300, LOUISVILLE, KY 40223-5005
(502) 882-9379
(502) 805-0526
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
007823
KY
Other
Enumeration date
11/01/2019
Last updated
07/31/2025
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