Individual
RONALD FULLER
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
23 E MAIN ST, MANCHESTER, GA 31816-2114
(678) 432-4755
(678) 432-4753
Mailing address
PO BOX 307, MANCHESTER, GA 31816-0307
(678) 432-4755
(678) 432-4753
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
005224
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CHIRO005224
STATE LIC
GA
Enumeration date
02/20/2006
Last updated
07/08/2007
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