Fuller, Jordan Louis

Fuller, Jordan Louis is an individual health care provider with primary practice located at 840 Winter St , Waltham MA 02451-1433. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Sports Medicine, Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist. Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist is his primary health care specialty. Fuller, Jordan Louis can be contacted via phone (781) 487-9944.

Contact Information

Primary practice address
840 Winter St Waltham MA 02451-1433
Phone: (781) 487-9944
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Sports Medicine 2081S0010X 3209 Massachusetts
Respiratory, Developmental, Rehabilitative and Restorative Service Providers / Physical Therapist 225100000X 26548 Massachusetts

Profile Details

NPI number 1992214803
LBN Legal business name Fuller, Jordan Louis
Credentials PT, DPT, LAT, ATC
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 22nd, 2017
Last updated Nov 10th, 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.

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