Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Customized Equipment |
332BC3200X | 87 | All Other Suppliers | |
Durable Medical Equipment & Medical Supplies |
332B00000X | 54 | Other Medical Supply Company |
| NPI # | 1669793949 |
| LBN Legal business name | FULLER REHABILITATION AND CONSULTING SERVICES, INC. |
| Authorized official | CARTER FULLER - (PRESIDENT, CEO) |
| Entity | Organization |
| Organization subpart 1 | Yes |
| Enumeration date | 06/21/2010 |
| Last updated | 06/21/2010 - About 16 years ago |
| Identifiers | n/a |
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