Individual
BRIANNA LYNN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3776 MOUNTAINEER HIGHWAY, MABEN, WV 25870-2587
(304) 294-5610
(304) 294-2040
Mailing address
PO BOX 835, MULLENS, WV 25882-0835
(304) 294-5610
(304) 294-2040
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
11/08/2023
Last updated
11/08/2023
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