Organization
FULLER REHABILITATION AND CONSULTING SERVICES INC.
Active
Other names
Independent Living Aids
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA PATRICIA MULLIS (VICE PRESIDENT)
(706) 965-3801
Entity
Organization
Contact information
Practice address
1923 MADISON ST # C, CLARKSVILLE, TN 37043-5066
(931) 551-4445
(931) 551-4255
Mailing address
529 ROLLINS INDUSTRIAL BLVD, P.O. BOX 615, RINGGOLD, GA 30736-2872
(706) 965-6131
(706) 965-3801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
656
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
4581852
—
TN
Enumeration date
09/22/2006
Last updated
08/22/2020
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