ANDRE LAVAL FULLER

BREMERTON, WA
NPI1669618468
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: WA  P160039642)
Enumeration Date2008-12-29
Last Update Date2008-12-29
Business Address
Mr. ANDRE LAVAL FULLER PTA
560 LEBO BLVD
BREMERTON, WA 98310
Phone number: 971-206-5200
Mailing Address
Mr. ANDRE LAVAL FULLER PTA
4560 SE INTERNATIONAL WAY STE. 100 CONSONUS HEALTHCARE SERVICES
MILWAUKIE, OR 97222
Phone number: 971-206-5200
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