Individual
CHRISTINA FULLEM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDN
Contact information
Practice address
8714 S MAIN ST, POLAND, NY 13431-2302
(315) 292-8285
Mailing address
8714 S MAIN ST, POLAND, NY 13431-2302
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
940276
NY
Other
Enumeration date
03/30/2021
Last updated
03/30/2021
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