MALLORY FULTON

LOUISVILLE, KY
NPI1154715886
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: IN  06004965A)
Additional Taxonomies225200000X Physical Therapy Assistant
(Licence: IL  160.006801)
Enumeration Date2015-03-19
Last Update Date2015-03-19
Business Address
-- MALLORY FULTON
2701 CHESTNUT STATION CT
LOUISVILLE, KY 40299-6395
Phone number: 800-335-1060
Mailing Address
-- MALLORY FULTON
2915 LINCOLN ST
HIGHLAND, IN 46322-2139
Phone number: 219-902-5962