Mary R Fuller, PT
Physical Therapist in Fort Gordon, GA. Individual provider (NPI-1).
NPI number1407183239
StatusActive
Last updated in NPPESJul 24, 2015
Details
- NPI
- 1407183239
- Entity type
- Individual (NPI-1)
- Name
- Mary R Fuller
- Credential
- PT
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Nov 16, 2009
- Last updated
- Jul 24, 2015
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 225100000X | Physical Therapist | 558 | MS | Yes |
Practice location
300 W Hospital RdSinterdisciplinary Pain Management Center
Fort Gordon, GA 30905-5741
Phone 706-787-1473
Mailing address
300 W Hospital RdSinterdisciplinary Pain Management Center
Fort Gordon, GA 30905-5741
Phone 706-787-1473
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All 17 Physical Therapist providers in Fort Gordon · All 561 providers in Fort Gordon
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