Individual
MRS. AMBER RAE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
3501 S LOOP 289, LUBBOCK, TX 79423-1139
(806) 796-1774
Mailing address
11103 EVANSTON AVE, LUBBOCK, TX 79424-6469
(214) 235-3674
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
2126973
TX
Other
Enumeration date
06/07/2016
Last updated
02/06/2017
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