Individual provider · Type 1 NPI

Daniel W. Fuller, ATC. LAT.

Specialist · Tyler, TX

NPI number 1750586509 Active

Practice location

3414 Golden Rd
Tyler, TX 75701-8336

Call (903) 939-7500 Map

Fax (903) 597-1245

Mailing address

447 Redbud Cir
Whitehouse, TX 75791-4405

Specialties and licenses

TaxonomyCodeLicense
Specialist Primary 174400000XAT1427 (TX)

Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

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About NPI 1750586509

Daniel W. Fuller, ATC. LAT.'s National Provider Identifier is 1750586509, issued on Jun 20, 2007. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Tyler, TX. The record was last updated on Jul 8, 2007.