Individual
JESSICA FULLNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
1301 GRUNDMAN BLVD, NEBRASKA CITY, NE 68410-3319
(402) 873-8918
Mailing address
1103 SCENIC DR, NEBRASKA CITY, NE 68410-1456
(402) 677-0646
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3500
NE
Other
Enumeration date
09/04/2015
Last updated
09/04/2015
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