Mino Fuller

NPI #1063048890 in Corvallis, Oregon

Provider Information

NPI Number: 1063048890
Entity Type: Individual
Name: Mino Fuller
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Mechanotherapist
Enumeration Date: Mar 12, 2020
Last Updated: Mar 12, 2020

Practice Location

Address: 1760 SW 3RD ST
City: Corvallis
State: Oregon
ZIP Code: 97333-1725
Phone: (720) 323-8971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Mechanotherapist	172M00000X	Primary

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