National Provider Identifier
Timothy Michael Fullmer, MSPT
Timothy Michael Fullmer, MSPT is listed in the NPPES registry with a primary specialty of Physical Therapist in Waverly, NY and a listed phone number of (607) 687-2495.
Profile Overview
- NPI
- 1104989268
- Provider Type
- Individual
- Primary Specialty
- Physical Therapist
- Enumeration Date
- December 19, 2006
- Last Updated
- March 26, 2021
Practice Location
- 150 Broad St
- Waverly, NY 14892-1361
Phone: (607) 687-2495
Specialties
- Physical Therapist (225100000X)
- Physical Therapist (225100000X)
Endpoints
- tfullmer143205@direct-guthrie.org
Direct Messaging Address | Direct | Waverly, NY 14892
Full Record
- NPI
- 1104989268
- Entity Type
- Individual
- Last Name
- Fullmer
- First Name
- Timothy
- Middle Name
- Michael
- Name Prefix
- Mr.
- Credential
- MSPT
- Mailing Street Address
- 150 Broad St
- Mailing City
- Waverly
- Mailing State
- NY
- Mailing ZIP Code
- 14892-1361
- Mailing Country
- US
- Mailing Phone
- (607) 687-2495
- Practice Street Address
- 150 Broad St
- Practice City
- Waverly
- Practice State
- NY
- Practice ZIP Code
- 14892-1361
- Practice Country
- US
- Practice Phone
- (607) 687-2495
- Enumeration Date
- December 19, 2006
- Last Updated
- March 26, 2021
- Sex
- Male
- Sole Proprietor
- Yes
- Certification Date
- March 25, 2021
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Physical Therapist (225100000X), Physical Therapist (225100000X)