| NPI | 1649872201 |
|---|---|
| Professional Name | DONALD V FULLER |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2255A2300X Specialist/Technologist Athletic Trainer (Licence: KY AT1608) |
| Enumeration Date | 2020-11-09 |
| Last Update Date | 2020-11-09 |