Individual
CODY FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CPO
Contact information
Practice address
6 OLD GROVE RD, GREENVILLE, SC 29605-4769
(864) 552-9772
Mailing address
703 N FANT ST STE A, ANDERSON, SC 29621-5705
(864) 622-0900
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
04/23/2021
Last updated
04/23/2021
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