Individual
EUGENE EDWARD FULLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
10325 LIBERTY CV, TWINSBURG, OH 44087-4913
(216) 272-5606
Mailing address
10325 LIBERTY CV, TWINSBURG, OH 44087-4913
(216) 272-5606
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN-085126
OH
Other
Enumeration date
11/23/2015
Last updated
04/15/2016
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