Chuck B Fuller, PA-C
NPI #1124015102 in Twin Falls, Idaho
Provider Information
- NPI Number
- 1124015102
- Entity Type
- Individual
- Name
- Chuck B Fuller, PA-C
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA-C
- Enumeration Date
- Oct 4, 2005
- Last Updated
- Jan 10, 2008
Practice Location
- Address
- 660 SHOSHONE ST E
- Address 2
- SUITE 130
- City
- Twin Falls
- State
- Idaho
- ZIP Code
- 83301-6110
- Phone
- (208) 732-3400
Specialties & Taxonomy Codes
| Specialty |
|---|
| Physician Assistant |
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