Individual provider · Type 1 NPI
Misty Marie Fullerton, DC
Chiropractor · Phoenix, AZ
NPI number
1508120700
Active
Practice location
2801 W Northern Ave
Phoenix, AZ 85051-6646
Fax (602) 242-4169
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Chiropractor Primary | 111N00000X | 8252 (AZ) |
Chiropractor: A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
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About NPI 1508120700
Misty Marie Fullerton, DC's National Provider Identifier is 1508120700, issued on Jul 2, 2012. The primary taxonomy on file is Chiropractor (111N00000X), and the practice location is in Phoenix, AZ. The record was last updated on Jul 2, 2012.