EARLY R FULLER

GREEN BAY, WI
NPI1518037613
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: WI  2418)
Enumeration Date2006-11-08
Last Update Date2007-07-08
Business Address
Mr. EARLY R FULLER CADCIII
2150 MEMORIAL DR STE 213
GREEN BAY, WI 54303-6335
Phone number: 920-498-3383
Mailing Address
Mr. EARLY R FULLER CADCIII
2150 MEMORIAL DR STE 213
GREEN BAY, WI 54303-6335
Phone number: 920-498-3383
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