Most Relevant Information
Provider Data
| NPI Number: | 1003023425 |
| Provider Name: | MARK DOUGLAS FULLMER D.C. |
| Entity Type: | Individual |
| Taxonomy Code: | 111N00000X |
| Specialty: | Chiropractor |
| License Number: | 20590 |
Most Important Dates
| Enumeration Date: | 05/16/2007 |
| Last Updated: | 08/18/2010 |
Provider Practice Location
471 AINSLEY AVE
YUBA CITY
CA
959914105
Practice Location Phone/Fax
| Phone: | 5307553200 |
| Fax: | 5307553205 |
Provider Mailing Location
471 AINSLEY AVE
YUBA CITY
CA
959914105
Provider Mailing Phone/Fax
| Phone: | 5307553200 |
| Fax: | 5307553205 |