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1104587005
GINA MARIE FULLER
GARDENDALE, AL
NPI
1104587005
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: AL 1593)
Enumeration Date
2022-01-04
Last Update Date
2022-01-04
Business Address
GINA MARIE FULLER ATC
540 MELONIE LN
GARDENDALE, AL 35071-2231
Phone number: 334-648-6110
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Mailing Address
GINA MARIE FULLER ATC
540 MELONIE LN
GARDENDALE, AL 35071-2231
Phone number: 334-648-6110
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