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1033628805
DWIGHT E FULTZ
PARK RAPIDS, MN
NPI
1033628805
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
103T00000X Psychologist
(Licence: MN LP4277)
Enumeration Date
2017-09-25
Last Update Date
2017-09-25
Business Address
DWIGHT E FULTZ PhD, LP
1003 HOLLINGER ST
PARK RAPIDS, MN 56470-1300
Phone number: 218-366-2636
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Mailing Address
DWIGHT E FULTZ PhD, LP
2310 S LAKE IRVING DR SW
BEMIDJI, MN 56601-8859
Phone number: 218-751-1811
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