Individual
TERRANCE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
2725 E SKELLY DR, TULSA, OK 74105-6241
(918) 592-1622
Mailing address
8213 E 32ND PL, TULSA, OK 74145-1460
(918) 621-6551
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
01/20/2011
Last updated
01/20/2011
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