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1982270088
JALISA FULLER
BOSSIER CITY, LA
NPI
1982270088
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
172A00000X Driver
(Licence: LA 009494849)
Enumeration Date
2021-05-28
Last Update Date
2021-05-28
Business Address
JALISA FULLER
1621 WILLIAMSBURG DR
BOSSIER CITY, LA 71112-3165
Phone number: 318-730-2368
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Mailing Address
JALISA FULLER
1621 WILLIAMSBURG DR
BOSSIER CITY, LA 71112-3165
Phone number: 318-730-2368
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