Individual
DONTE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
25 SAND FORK RD, LINN, WV 26384-8235
(304) 462-8858
Mailing address
25 SAND FORK RD, LINN, WV 26384-8235
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
—
—
Other
Enumeration date
02/26/2021
Last updated
02/26/2021
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