Dwight E Fultz, PHD, LP

NPI #1033628805 in Park Rapids, Minnesota

Provider Information

NPI Number: 1033628805
Entity Type: Individual
Name: Dwight E Fultz, PHD, LP
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Psychologist
Credential: PHD, LP
Enumeration Date: Sep 25, 2017
Last Updated: Sep 25, 2017

Practice Location

Address: 1003 HOLLINGER ST
City: Park Rapids
State: Minnesota
ZIP Code: 56470-1300
Phone: (218) 366-2636

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Psychologist	103T00000X	Primary

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