JOHN ALLAN CLAYTON FULLING

GREAT LAKES, IL
NPI1083873905
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2008-06-05
Last Update Date2008-06-05
Business Address
Mr. JOHN ALLAN CLAYTON FULLING IDC
2410 SAMPSON ST FISHER BMC #237
GREAT LAKES, IL 60088
Phone number: 847-688-5556
Mailing Address
Mr. JOHN ALLAN CLAYTON FULLING IDC
2524 N POPLAR ST
WAUKEGAN, IL 60087-3127
Phone number: 619-203-7508
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