Individual
CATHY A FULP
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
O.D.
Contact information
Practice address
10564 N MAIN ST, STE E, ARCHDALE, NC 27263-2472
(336) 434-4033
(336) 434-4035
Mailing address
PO BOX 4370, ARCHDALE, NC 27263-4370
(336) 434-4033
(336) 434-6680
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1388
NC
152WP0200X
Pediatric Optometrist
1388
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0929A
BCBSNC
NC
05
—
890929A
—
NC
Enumeration date
06/30/2005
Last updated
10/13/2010
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