Organization
DANIEL G. FULLER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANIEL G FULLER O.D (OWNER)
(901) 754-2020
Entity
Organization
Contact information
Practice address
2075 EXETER RD, SUITE70, GERMANTOWN, TN 38138-3962
(901) 754-2020
(901) 756-9537
Mailing address
2075 EXETER ROAD, SUITE70, GERMANTOWN, TN 38138
(901) 754-2020
(901) 756-9537
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0600002014
TN
Other
Enumeration date
06/27/2007
Last updated
09/14/2007
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