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General NPI Number Information
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NPI Number | 1679830574
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Entity Type | Organization
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Legal Business Name | FULMORE & ASSOCIATES CHIROPRACTIC AND SPINAL INJURY CENTERS, PA
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Dates
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Enumeration Date | 04/16/2012
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Last Update Date | 04/16/2012
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Provider Practice Location Address
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Address Line | 781 MAITLAND AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6835
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Country | US
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Telephone | 407-339-2888
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Fax | 407-831-3085
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Provider Business Mailing Address
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Address Line | 781 MAITLAND AVE
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City | ALTAMONTE SPRINGS
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State | FL
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Zip | 32701-6835
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Country | US
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Telephone | 407-339-2888
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Fax | 407-831-3085
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Authorized Official
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Title or Position | DOCTOR IN CHARGE
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Name | RONALD L FULMORE SR.
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Credential | D.C.
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Telephone | 407-339-2888
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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 | CH4735
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License Number State | FL
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