Individual
LYNN FULFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3901 S 7TH ST, TERRE HAUTE, IN 47802-5709
(812) 237-1161
Mailing address
3901 S 7TH ST, TERRE HAUTE, IN 47802-5709
(812) 237-1161
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
37002239A
IN
Other
Enumeration date
02/07/2013
Last updated
02/07/2013
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