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Individual

BRIAN THOMAS FULTON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DO

Contact information

Practice address
180 10TH ST SE, SUITE 201, LE MARS, IA 51031-2550
(712) 546-4624
Mailing address
180 10TH ST SE, SUITE 201, LE MARS, IA 51031-2550
(712) 546-4624

Taxonomy

Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
01720
IA

Other

Enumeration date
04/26/2006
Last updated
09/03/2010
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