Individual
JAMES FULLAGAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LMSW
Contact information
Practice address
222 SOUTHWIND PL, MANHATTAN, KS 66503-3123
(800) 423-1342
(785) 628-3113
Mailing address
509 E ELM ST, SALINA, KS 67401-2353
(800) 423-1342
(785) 628-3113
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
4513
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200731690B
—
KS
Enumeration date
07/19/2011
Last updated
09/14/2020
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