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1003558107
GRANT FULLER
DALLAS, TX
NPI
1003558107
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
224Z00000X Occupational Therapy Assistant
(Licence: TX 217275)
Enumeration Date
2022-04-08
Last Update Date
2022-04-08
Business Address
GRANT FULLER OTA
12770 COIT RD STE 870
DALLAS, TX 75251-1455
Phone number: 501-794-7866
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Mailing Address
GRANT FULLER OTA
12770 COIT RD STE 870
DALLAS, TX 75251-1455
Phone number:
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