Individual
RYAN FULLINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
8500 MARYLAND AVE APT 513, SAINT LOUIS, MO 63124-2318
(262) 364-9221
Mailing address
8500 MARYLAND AVE APT 513, SAINT LOUIS, MO 63124-2318
(262) 364-9221
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
14512-24
WI
225100000X
Physical Therapist
Primary
2022013468
MO
Other
Enumeration date
12/20/2018
Last updated
10/09/2024
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