Individual
ALISHA M FULKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.T., DPT
Contact information
Practice address
1948 MESQUITE AVE, SUITE 101, LAKE HAVASU CITY, AZ 86403-5777
(928) 854-4776
(928) 854-4857
Mailing address
1948 MESQUITE AVE, SUITE 101, LAKE HAVASU CITY, AZ 86403-5777
(928) 854-4776
(928) 854-4857
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
10059
AZ
Other
Enumeration date
11/15/2012
Last updated
11/15/2012
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