MICHAEL CHARLES FULLER

COLTON, CA
NPI1083084115
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: CA  17771)
Enumeration Date2015-10-01
Last Update Date2024-07-02
Business Address
MICHAEL CHARLES FULLER
1076 SANTO ANTONIO DR
COLTON, CA 92324-8103
Phone number: 909-433-9824
Mailing Address
MICHAEL CHARLES FULLER
1076 SANTO ANTONIO DR
COLTON, CA 92324-8103
Phone number: 909-433-9824