Individual
MR. BRIAN GEORGE FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
15 PORTERS GLEN PL, DURHAM, NC 27713-9164
(919) 452-8264
Mailing address
15 PORTERS GLEN PL, DURHAM, NC 27713-9164
(919) 452-8264
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
5564
NC
Other
Enumeration date
03/21/2006
Last updated
02/23/2011
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