Provider Demographics
NPI:1275746620
Name:FULLER, CATHERINE JOY (PHD)
Entity Type:Individual
Prefix:MRS
First Name:CATHERINE
Middle Name:JOY
Last Name:FULLER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 WEAVER DR
Mailing Address - Street 2:
Mailing Address - City:EIGHT MILE
Mailing Address - State:AL
Mailing Address - Zip Code:36613-2820
Mailing Address - Country:US
Mailing Address - Phone:251-679-7575
Mailing Address - Fax:
Practice Address - Street 1:3480 SPRING HILL AVE
Practice Address - Street 2:
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36608-1523
Practice Address - Country:US
Practice Address - Phone:251-341-0927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes226300000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersKinesiotherapist