CARLY DION FULTZ

BRADENTON, FL
NPI1922449313
Former NameCARLY DION PANTON
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy225200000X Physical Therapy Assistant
(Licence: FL  PTA23455)
Enumeration Date2013-07-12
Last Update Date2013-07-12
Business Address
-- CARLY DION FULTZ PTA
4307 1ST AVE NE
BRADENTON, FL 34208-5431
Phone number: 941-961-0645
Mailing Address
-- CARLY DION FULTZ PTA
4307 1ST AVE NE
BRADENTON, FL 34208-5431
Phone number: 941-961-0645