Individual
BREANNA MARIA FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 INDIAN RUN RD, AVONDALE, PA 19311-1509
(443) 752-9120
Mailing address
400 INDIAN RUN RD, AVONDALE, PA 19311-1509
(443) 752-9120
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
08/24/2023
Last updated
08/24/2023
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