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General NPI Number Information
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NPI Number | 1083603658
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Entity Type | Organization
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Legal Business Name | JOHN D FULKERSON, DC PA
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 10/18/2007
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Provider Practice Location Address
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Address Line | 132 N ARMSTRONG AVE
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City | TULIA
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State | TX
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Zip | 79088-2232
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Country | US
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Telephone | 806-995-4699
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Fax | 806-995-4706
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Provider Business Mailing Address
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Address Line | PO BOX 283
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City | TULIA
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State | TX
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Zip | 79088-0283
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Country | US
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Telephone | 806-995-4699
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Fax | 806-995-4706
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JOHN DAVID FULKERSON
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Credential | DC
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Telephone | 806-995-4699
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number | 9985
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License Number State | TX
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