Individual
JOHN MARTIN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
100 RIDGE RD, VERSAILLES, KY 40383-1333
(859) 229-4674
Mailing address
100 RIDGE RD, VERSAILLES, KY 40383-1333
(859) 229-4674
Taxonomy
Speciality
Code
Description
License number
State
1835P0018X
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
Primary
009884
KY
Other
Enumeration date
10/16/2020
Last updated
10/16/2020
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