Fuller, Bryan Carroll
Fuller, Bryan Carroll is an sole proprietor health care provider with primary practice located at 612 Rio Rd W Ste 5 , Charlottesville VA 22901-1412. He recently has 2 registered licenses in different health care specialties including Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist is his primary health care specialty. Fuller, Bryan Carroll can be contacted via phone (434) 529-8882.Contact Information
Primary practice address
612 Rio Rd W Ste 5
Charlottesville VA 22901-1412
Phone: (434) 529-8882
Fax: (434) 529-8882
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Prosthetist | 224P00000X | 1298 | Delaware |
| Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Orthotist | 222Z00000X | 1298 | Delaware |
Profile Details
| NPI number | 1487089124 |
|---|---|
| LBN Legal business name | Fuller, Bryan Carroll |
| Credentials | CPO |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 12th, 2013 |
| Last updated | Jul 21st, 2022 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1487089124 | NPPES |
| Virginia | MEDICAID | 1215362850 |
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