Fullerton, Mark B

Fullerton, Mark B is an sole proprietor health care provider with primary practice located at 109 S Main St , Woodruff SC 29388-1849. He recently has only one registered license in Chiropractic Providers / Chiropractor, which is considered as his primary health care specialty. Fullerton, Mark B can be contacted via phone (864) 476-2200.

Contact Information

Primary practice address
109 S Main St Woodruff SC 29388-1849
Phone: (864) 476-2200
Fax: (864) 476-0757
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Chiropractic Providers / Chiropractor 111N00000X 1130 South Carolina
Chiropractic Providers / Chiropractor 111N00000X DC-002887-L Pennsylvania

Profile Details

NPI number 1336290261
LBN Legal business name Fullerton, Mark B
Credentials Doctor of Chiropractic (DC)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 16th, 2007
Last updated Nov 21st, 2007 - about 18 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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Identifiers

StateTypeNumberIssuer
All States NPI 1336290261 NPPES
South Carolina MEDICAID CH1130

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