Individual
MS. AMANDA LOUISE FULMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1600 ST LUKES BLVD, EASTON, PA 18045-5671
(484) 503-4500
(484) 503-4501
Mailing address
1600 ST LUKES BLVD, EASTON, PA 18045-5671
(484) 503-4500
(484) 503-4501
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
OA002708
PA
Other
Enumeration date
08/22/2011
Last updated
04/01/2016
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