Individual
KURT B. FULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
C. PED., BOC-O, CO
Contact information
Practice address
2100 S BRENTWOOD BLVD STE A, SPRINGFIELD, MO 65804-2534
(417) 888-0887
Mailing address
638 SOMMER LN, BILLINGS, MO 65610-8324
(417) 744-4152
Taxonomy
Speciality
Code
Description
License number
State
335E00000X
Prosthetic/Orthotic Supplier
Primary
—
—
Other
Enumeration date
03/08/2007
Last updated
07/08/2007
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