BRYAN CARROLL FULLER

CHARLOTTESVILLE, VA
NPI1487089124
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy222Z00000X Orthotist
(Licence: DE  1298)
Additional Taxonomies224P00000X Prosthetist
(Licence: DE  1298)
Enumeration Date2013-09-12
Last Update Date2022-07-21
Business Address
Mr. BRYAN CARROLL FULLER CPO
612 RIO RD W STE 5
CHARLOTTESVILLE, VA 22901-1412
Phone number: 434-529-8882
Mailing Address
Mr. BRYAN CARROLL FULLER CPO
612 RIO RD W STE 5
CHARLOTTESVILLE, VA 22901-1412
Phone number: 434-529-8882