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1083747455
WELDON FULLER
LOUISVILLE, KY
NPI
1083747455
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: KY 128)
Enumeration Date
2007-03-14
Last Update Date
2007-07-08
Business Address
-- WELDON FULLER
600 S PRESTON ST
LOUISVILLE, KY 40202-1716
Phone number: 502-589-1100
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Mailing Address
-- WELDON FULLER
101 W MUHAMMAD ALI BLVD
LOUISVILLE, KY 40202-1423
Phone number: 502-589-8600
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