MARK THERON FULTON

COLUMBIA, SC
NPI1235234170
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence:   1032992)
Enumeration Date2006-09-14
Last Update Date2007-07-08
Business Address
MR. MARK THERON FULTON PA-C
4500 STUART ST MACH CREDENTIALS
COLUMBIA, SC 29207-5700
Phone number: 803-751-6634
Mailing Address
MR. MARK THERON FULTON PA-C
2 ANGUS RD
COLUMBIA, SC 29223-7745
Phone number: 803-865-9794
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