Individual
DRUSILLA FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
44 ANTIOCH DR, KINGSTREE, SC 29556-5733
(704) 293-5718
Mailing address
44 ANTIOCH DR, KINGSTREE, SC 29556-5733
(704) 293-5718
Taxonomy
Speciality
Code
Description
License number
State
332BP3500X
Parenteral & Enteral Nutrition Supplies (DME)
Primary
—
SC
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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