Larry D Fullmer

NPI #1821075912 in Sandy, Utah

Provider Information

NPI Number: 1821075912
Entity Type: Individual
Name: Larry D Fullmer
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Dec 29, 2005
Last Updated: Feb 14, 2014

Practice Location

Address: 9720 S 1300 E
Address 2: #W200
City: Sandy
State: Utah
ZIP Code: 84094-3712
Phone: (801) 572-0690

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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