Organization
FULLER REHABILITATION AND CONSULTING SERVICES INC.
Active
Other names
Independent Living Aids
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. WANDA PATRICIA MULLIS (VICE PRESIDENT)
(706) 965-0323
Entity
Organization
Contact information
Practice address
6064 WILMINGTON PIKE, SUGARCREEK PLAZA SHOPPING CENTER, DAYTON, OH 45459-7006
(937) 848-4300
(937) 848-4310
Mailing address
529 ROLLINS INDUSTRIAL BLVD, P.O. BOX 615, RINGGOLD, GA 30736-2872
(706) 965-6131
(706) 965-3801
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2552910
—
OH
Enumeration date
09/20/2006
Last updated
08/22/2020
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