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Individual

MRS. BARBARA JEANNE FULLER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
458 FORWARD PASS RD SW, PATASKALA, OH 43062-7429
(614) 562-3188
Mailing address
458 FORWARD PASS RD SW, PATASKALA, OH 43062-7429
(614) 562-3188

Taxonomy

Speciality
Code
Description
License number
State
171W00000X
Contractor
Primary

Other

Enumeration date
04/19/2007
Last updated
07/08/2007
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