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Contact Information

CASSANDRA A FULLER, DPT
5310 SOUTH PARK DRIVE
SUITE 4
JACKSON, WY83002
 Phone: 307-262-6372
 Fax: 307-200-6403
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Physical Therapist

225100000X 65 Physical Therapist in Private Practice
Indicates primary specialty

NPI Profile & details for CASSANDRA A FULLER · (Female)

NPI Number 1053796003
Status Active
Credentials DPT (Doctorate of Physical Therapy)
Entity Individual
Enumeration date 07/20/2015
Last updated 03/07/2024 - About 2 years ago
Sole proprietor 1 No
Identifiers
  • WY License # PT1570
  • WY Other PT1570 WYOMING LICENSE
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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