Individual
MARK R FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
12276 CLEVELAND AVE NW APT 1, UNIONTOWN, OH 44685-9189
(330) 294-8436
(330) 253-9938
Mailing address
12276 CLEVELAND AVE NW APT 1, UNIONTOWN, OH 44685-9189
(330) 294-8436
(330) 253-9938
Taxonomy
Speciality
Code
Description
License number
State
172A00000X
Driver
Primary
—
—
Other
Enumeration date
10/14/2022
Last updated
10/14/2022
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