Individual
DEBRA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
4287 OTTERBEIN RD, RUSHVILLE, OH 43150-9607
(740) 743-1168
(740) 743-1168
Mailing address
4287 OTTERBEIN RD, RUSHVILLE, OHIO 43150
(740) 743-1168
(740) 743-1168
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
401115530710
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0105578
—
OH
Enumeration date
02/12/2015
Last updated
02/12/2015
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