CHAD B FULLMER

PROVO, UT
NPI1285760033
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225100000X Physical Therapist
(Licence: UT  4877705-2401)
Additional Taxonomies225100000X Physical Therapist
(Licence: WA  PT00010369)
Enumeration Date2007-02-26
Last Update Date2015-07-15
Business Address
CHAD B FULLMER M.P.T.
5314 RIVER RUN DR
PROVO, UT 84604-5691
Phone number: 801-426-4905
Mailing Address
CHAD B FULLMER M.P.T.
1215 W 2420 N
PLEASANT GROVE, UT 84062-8083
Phone number: 801-635-6602