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1306984778
ROBERT R FULGHAM
SAN ANDREAS, CA
NPI
1306984778
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2007-02-01
Last Update Date
2007-07-08
Business Address
-- ROBERT R FULGHAM
891 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249-9713
Phone number: 209-754-6555
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Mailing Address
-- ROBERT R FULGHAM
891 MOUNTAIN RANCH RD
SAN ANDREAS, CA 95249-9713
Phone number: 209-754-6555
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