Stanley Fuller

NPI #1073795423 in Fremont, Ohio

Provider Information

NPI Number
1073795423
Entity Type
Organization
Organization Name
Stanley Fuller
Primary Specialty
Custodial Care Facility - Adult Care Home
Enumeration Date
Nov 28, 2007
Last Updated
Nov 28, 2007

Practice Location

Address
117 N WAYNE ST
State
Ohio
ZIP Code
43420-2431
Phone
(419) 307-2984

Authorized Official

Name
MR. STANLEY B FULLER
Title
LPN
Phone
(419) 307-2984

Specialties & Taxonomy Codes

Specialty
Custodial Care Facility - Adult Care HomeAdult Care Home

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