TRYSTEN FUGATE

MATTOON, IL
NPI1093386393
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YM0800X Counselor, Mental Health
Enumeration Date2021-07-07
Last Update Date2021-07-07
Business Address
TRYSTEN FUGATE BS
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5735
Mailing Address
TRYSTEN FUGATE BS
750 BROADWAY AVE E
MATTOON, IL 61938-4610
Phone number: 217-238-5735
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