NPI | 1689806358 |
---|---|
Former Legal Business Name | FULLER HEALTH GROUP PC |
Entity Type | Organization |
Authorized Contact | BRIAN JAY FULLER Chiropractic Physician 708-705-9494 |
Organization Subpart ? | No |
Primary Taxonomy | 111N00000X Chiropractor |
Additional Taxonomies | 225100000X Physical Therapist |
Enumeration Date | 2009-08-14 |
Last Update Date | 2021-03-23 |