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1427008150
GARY TRENT FULLMER
CHANDLER, AZ
NPI
1427008150
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
363AS0400X Physician Assistant Surgical
(Licence: AZ 2774)
Enumeration Date
2006-05-11
Last Update Date
2024-12-05
Business Address
GARY TRENT FULLMER P.A.-C
485 S DOBSON RD STE 110
CHANDLER, AZ 85224-5600
Phone number: 480-728-4470
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Mailing Address
GARY TRENT FULLMER P.A.-C
PO BOX 33269
PHOENIX, AZ 85067-3269
Phone number: 602-406-4786
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