Edward A Fulghum, PTA
Physical Therapy Assistant in Smithfield, NC. Individual provider (NPI-1).
NPI number1043799208
StatusActive
Last updated in NPPESAug 8, 2018
Details
- NPI
- 1043799208
- Entity type
- Individual (NPI-1)
- Name
- Edward A Fulghum
- Credential
- PTA
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Aug 8, 2018
- Last updated
- Aug 8, 2018
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225200000X | Physical Therapy Assistant | 5326 | NC | Yes |
Practice location
509 N Brightleaf BlvdSmithfield, NC 27577-4407
Phone 919-934-8171
Mailing address
1209 Peele RdClayton, NC 27520-6863
Phone 252-292-2816
Other practice locations
902 Berkshire Rd
Smithfield, NC 27577-4731
Smithfield, NC 27577-4731
Phone 919-934-3171
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