| Nathan Thomas Fullam, DPT | |
|
115 N Route 73 Unit 80, West Berlin, NJ 08091-9202 | |
| (856) 335-4938 | |
| Not Available |
| Full Name | Nathan Thomas Fullam |
|---|---|
| Gender | Male |
| Speciality | Physical Therapist In Private Practice |
| Experience | 5 Years |
| Location | 115 N Route 73 Unit 80, West Berlin, New Jersey |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265101935 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225100000X | Physical Therapist | 40QA02040500 (New Jersey) | Primary |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Ipta Clinical, Llc | 0749456119 | 105 |
| Provider Name | Ipta Clinical, Llc |
|---|---|
| Provider Type | Part B Supplier - Physical/occupational Therapy Group In Private Practice |
| Provider Identifiers | NPI Number: 1760764484 PECOS PAC ID: 0749456119 Enrollment ID: O20120106000040 |
| Mailing Address | Practice Location Address |
|---|---|
| Nathan Thomas Fullam, DPT 1225 Tristram Cir, Mantua, NJ 08051-2245 Ph: (484) 947-8823 | Nathan Thomas Fullam, DPT 115 N Route 73 Unit 80, West Berlin, NJ 08091-9202 Ph: (856) 335-4938 |
Sarah E Obuchowski, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 115 N Route 73 Unit 80, West Berlin, NJ 08091 Phone: 856-335-4938 | |
Alyssa Hope Mcminn, PT, DPT, LAT, ATC Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 115 N Route 73 Unit 80, West Berlin, NJ 08091 Phone: 856-335-4938 | |
Christopher Patrick Niemann Jr., DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 91 Haddon Ave, West Berlin, NJ 08091 Phone: 267-250-0443 | |
Jonah Gil, PT, DPT Physical Therapist Medicare: Not Enrolled in Medicare Practice Location: 115 N Route 73 Unit 80, West Berlin, NJ 08091 Phone: 856-335-4938 | |
Dr. Benjamin R Harris, PT, DPT Physical Therapist Medicare: Medicare Enrolled Practice Location: 115 Nj-73, Unit 80, West Berlin, NJ 08091 Phone: 856-335-4938 | |
Dr. Taylor Michelle Wittstock, PT, DPT Physical Therapist Medicare: Accepting Medicare Assignments Practice Location: 115 N Route 73 Unit 80, West Berlin, NJ 08091 Phone: 856-335-4938 |