Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jacqueline Fullam, MPT

Individual provider Physical Therapist · NPI 1447340724

Jacqueline Fullam, MPT is a Physical Therapist in Private Practice in York, Pennsylvania. Qualified in 1992, 34 years ago. Licensed in Pennsylvania.

Years since qualifying
34
Licensed in
PA
In the registry since
2006
What do these letters mean?
MPT — Master of Physical Therapy
The master's-level physical therapy degree awarded before the DPT became standard.

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Practice location Address checks out

2300 Pleasant Valley Rd
York, PA 17402-9627
Phone: (717) 757-3537
Fax: (717) 718-9701
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physical Therapist (primary) Taxonomy 225100000X · Licence PT015090 (PA)

Record details

NPI number1447340724
Entity typeIndividual (Type 1)
GenderFemale
Credentials MPT
Sole proprietorNo
NPI enumeratedOctober 15, 2006
Last updated in NPPESMay 6, 2020
Certification dateMay 6, 2020
Mailing address790 Remington Blvd, Bolingbrook, IL 60440-4909

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICAL THERAPIST IN PRIVATE PRACTICE
Medical schoolOTHER
Graduated 1992 (34 years in practice)
Accepts Medicare assignment Not indicated

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