Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TIMOTHY MICHAEL FULLMER, MSPT
Active Sole ProprietorMR. TIMOTHY MICHAEL FULLMER, MSPT is a Physical Therapy Assistant healthcare provider located in WAVERLY, New York. NPI 1104989268 is currently active in the NPPES registry. Verify at CMS.
Physical Therapy Assistant · WAVERLY, NY
Registration Details
- NPI Number
- 1104989268
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 19, 2006 (19.650305441808 yrs)
- Last Updated
- Mar 26, 2021
- Licenses
-
022693 (NY)022693-1 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
150 BROAD STWAVERLY, NY, 148921361Browse NY providers · Browse ZIP 14892
- Phone
- 6076872495
- Primary Specialty
-
Physical Therapy Assistant
225100000X
- Additional Specialty
- Physical Therapy Assistant
Other Physical Therapy Assistant Providers in WAVERLY, NY
| Name | Credential | NPI |
|---|---|---|
| ANNE DEMOTT | BS | 1326092487 |
| MS. AMY KATHRYN BROWN | DPT | 1992997704 |
| MRS. PATRICIA LOUISE WARD | RPT | 1902042450 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.