Individual
RANDY CLAY FULK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
R.PH
Contact information
Practice address
101 FORBES DR, MARTINSBURG, WV 25404-0002
(304) 262-4697
Mailing address
101 FORBES DR, MARTINSBURG, WV 25404-0002
(304) 262-4697
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
RP0004427
WV
Other
Enumeration date
06/18/2011
Last updated
06/18/2011
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