Individual
MRS. MELISSA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
5230 WILLOW CREEK DR, STE. 101, SPRINGDALE, AR 72762-0876
(479) 866-9410
Mailing address
903 PEAK ST, CAVE SPRINGS, AR 72718-7108
(479) 790-1684
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA2281
AR
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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