JOHN ROBERT FULTS

BLOOMINGTON, IL
NPI1083777890
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy152W00000X Optometrist
(Licence: IL  46-006841)
Enumeration Date2006-12-19
Last Update Date2007-07-08
Business Address
-- JOHN ROBERT FULTS O.D.
1631 E EMPIRE ST
BLOOMINGTON, IL 61701-3531
Phone number: 309-662-4074
Mailing Address
-- JOHN ROBERT FULTS O.D.
114 E WILLIAMS ST
BROADWELL, IL 62634-6367
Phone number: 217-732-7422
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