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1134290331
JASON FULLER
SENECA, SC
NPI
1134290331
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
225100000X Physical Therapist
(Licence: SC 5295)
Enumeration Date
2006-11-11
Last Update Date
2007-12-04
Business Address
-- JASON FULLER DPT
12023 NORTH RADIO STATION RD. STE A
SENECA, SC 29678-0929
Phone number: 864-985-0770
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Mailing Address
-- JASON FULLER DPT
101 CROSS CREEK CT APT B
CENTRAL, SC 29630-4108
Phone number: 931-261-5569
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