CHRISTY LATASHA FULLER

DECATUR, GA
NPI1063852630
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy302F00000X Exclusive Provider Organization
(Licence: GA  MT008977)
Enumeration Date2013-06-27
Last Update Date2013-06-27
Business Address
Mrs. CHRISTY LATASHA FULLER LMT
2288 MIRIAM LN
DECATUR, GA 30032-5551
Phone number: 404-343-8848
Mailing Address
Mrs. CHRISTY LATASHA FULLER LMT
2759 DELK RD SE
MARIETTA, GA 30067-8847
Phone number: 404-343-8848
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