Provider Demographics
NPI:1912742230
Name:FULTON, GARRETT ALEXANDER (RSO, AHMM, BS BIO)
Entity type:Individual
Prefix:MR
First Name:GARRETT
Middle Name:ALEXANDER
Last Name:FULTON
Suffix:
Gender:M
Credentials:RSO, AHMM, BS BIO
Other - Prefix:MR
Other - First Name:ALEX
Other - Middle Name:
Other - Last Name:FULTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:RSO, AHMM, BS BIO
Mailing Address - Street 1:6169 BRANCH HILL GUINEA PIKE
Mailing Address - Street 2:
Mailing Address - City:MILFORD
Mailing Address - State:OH
Mailing Address - Zip Code:45150-2256
Mailing Address - Country:US
Mailing Address - Phone:513-716-7106
Mailing Address - Fax:
Practice Address - Street 1:6169 BRANCH HILL GUINEA PIKE
Practice Address - Street 2:
Practice Address - City:MILFORD
Practice Address - State:OH
Practice Address - Zip Code:45150-2256
Practice Address - Country:US
Practice Address - Phone:513-716-7106
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-27
Last Update Date:2024-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health