Individual
MRS. TERESA AUSTIN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4755 S COUNTY ROAD O, MAPLE, WI 54854-9159
(218) 269-7961
(715) 363-2615
Mailing address
4755 S COUNTY ROAD O, MAPLE, WI 54854-9159
(218) 269-7961
(715) 363-2615
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/12/2018
Last updated
03/12/2018
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