MR. Henry Fuller III, MASTER OF SCIENCE OT

NPI #1770891616 in Lisbon, Maine

Provider Information

NPI Number: 1770891616
Entity Type: Individual
Name: MR. Henry Fuller III, MASTER OF SCIENCE OT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Occupational Therapist
Credential: MASTER OF SCIENCE OT
Enumeration Date: Sep 14, 2010
Last Updated: Sep 14, 2010

Practice Location

Address: 33 MILL ST
City: Lisbon
State: Maine
ZIP Code: 04250-6810
Phone: (207) 353-4132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Occupational Therapist	225X00000X	Primary

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