Individual
ANDREA FULLER
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PT, DPT, SCS
Contact information
Practice address
3851 ROGER BROOKE DR, MCHE-QD/CREDENTIALS, FORT SAM HOUSTON, TX 78234-4501
(210) 916-2460
Mailing address
20823 STEVENS CREEK BLVD, STE 200, CUPERTINO, CA 95014-2112
(408) 252-6076
Taxonomy
Speciality
Code
Description
License number
State
2251S0007X
Sports Physical Therapist
Primary
05007204A
IN
Other
Enumeration date
11/02/2005
Last updated
10/07/2019
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