Most Relevant Information
Provider Data
| NPI Number: | 1003424656 |
| Provider Name: | CHRISTOPHER FULLER PT, DPT |
| Entity Type: | Individual |
| Taxonomy Code: | 225100000X |
| Specialty: | Physical Therapist |
| License Number: | PT34869 |
Most Important Dates
| Enumeration Date: | 07/20/2020 |
| Last Updated: | 11/08/2021 |
Provider Practice Location
655 W 8TH ST
JACKSONVILLE
FL
322096511
Practice Location Phone/Fax
| Phone: | 9042440411 |
| Fax: |
Provider Mailing Location
655 W 8TH ST
JACKSONVILLE
FL
322096511
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |