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Search › Utah › 101Y00000X

Ken Fullerton

NPI 1790141521 · on the registry since 2016

Practice

Address
900 Columbia Ln
Provo, UT 84604
Phone
(801) 375-4240
Organisation at this address
True North Academy, Llc
Northstar Youth Academy Llc
Inferred from a shared address, not stated in the registry.
Clinicians at this address
41

Registry record

Primary taxonomy
101Y00000X
101Y00000X
Sex
Male
Record last updated
2016-01-08

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Utah