Individual
EVELYN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDN, CDN
Contact information
Practice address
81 W BAYARD ST, SENECA FALLS, NY 13148-1807
(904) 239-0077
Mailing address
34 GREEN ST, SENECA FALLS, NY 13148-2026
(904) 239-0077
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
010110
NY
Other
Enumeration date
08/17/2020
Last updated
08/17/2020
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