Fullerton, John Reynolds
Fullerton, John Reynolds is an sole proprietor health care provider with primary practice located at Va Medical Center (620) 1700 Lincoln Avenue, Lebanon PA 17042-0000. He recently has only one registered license in Behavioral Health & Social Service Providers / Psychologist, which is considered as his primary health care specialty. Fullerton, John Reynolds can be contacted via phone (717) 272-6621.Contact Information
Primary practice address
Va Medical Center (620) 1700 Lincoln Avenue
Lebanon PA 17042-0000
Phone: (717) 272-6621
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Psychologist | 103T00000X | PS001071L | Pennsylvania |
Profile Details
| NPI number | 1255431037 |
|---|---|
| LBN Legal business name | Fullerton, John Reynolds |
| Credentials | D.ED. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 22nd, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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