Individual
MRS. JILL KATHLEEN FULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RD, LD, CDE
Contact information
Practice address
335 GLESSNER AVE, MANSFIELD, OH 44903-2269
(419) 526-8471
(419) 526-8939
Mailing address
1394 STATE ROUTE 603, ASHLAND, OH 44805-9723
(419) 207-0212
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
5038
OH
Other
Enumeration date
04/02/2007
Last updated
07/08/2007
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