Tara C Fulk

NPI #1427047026 in Bridgewater, Virginia

Provider Information

NPI Number: 1427047026
Entity Type: Individual
Name: Tara C Fulk
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Specialist
Enumeration Date: Oct 17, 2005
Last Updated: Oct 31, 2007

Practice Location

Address: 112 N RIVER RD
City: Bridgewater
State: Virginia
ZIP Code: 22812-1611
Phone: (540) 828-6443

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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