Individual
EVELYN FULLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
4617 JONESBORO RD, UNION CITY, GA 30291-2048
(770) 969-7458
(770) 969-9856
Mailing address
7360 HOBGOOD RD, FAIRBURN, GA 30213-2684
(404) 200-0531
(770) 969-9777
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
021868
GA
183500000X
Pharmacist
12094-40
WI
Other
Enumeration date
09/29/2011
Last updated
09/29/2011
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