Fulcrum Performance Lab, LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

FULCRUM PERFORMANCE LAB, LLC

Practice address

75 S Maple Ave
Marlton, NJ 08053-2032

Phone

(856) 607-2400

NPI assigned

Mar 30, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Charles Bruce Morris III, PH.D

Title

Chairman / Ceo

Phone

(609) 284-5456

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1585526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1594944000000",
    "number": "1205464823",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 S MAPLE AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532032",
            "telephone_number": "856-607-2400"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 S MAPLE AVE",
            "city": "MARLTON",
            "state": "NJ",
            "postal_code": "080532032",
            "telephone_number": "856-607-2400"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FULCRUM PERFORMANCE LAB, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-30",
        "last_updated": "2020-07-17",
        "certification_date": "2020-07-17",
        "status": "A",
        "authorized_official_last_name": "MORRIS",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "BRUCE",
        "authorized_official_title_or_position": "CHAIRMAN / CEO",
        "authorized_official_telephone_number": "609-284-5456",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_name_suffix": "III",
        "authorized_official_credential": "PH.D"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert S Friedman, MD
• Jane S. Friehling, D.O.
• Friends of Cyrus
• Friends of Cyrus II
• Dana Fulcher
• Full of Life Recovery Center
• Brittany Lynn Fulmer, OTR/L
• Camille Ann Fumo, M.S. CCC-SLP
• Alison Furman, OTR/L, DROT
• Natalie Susan Gaber, MSW LCSW

• Clinic/Center in Marlton, NJ
• Providers in Marlton, NJ by specialty
• Clinic/Center in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.