Organization · Type 2 NPI
Fulfilling Life PLLC
Specialist · Edwardsville, IL
NPI number
1922796408
Active
Practice location
3 Club Centre Ct Ste B1
Edwardsville, IL 62025-3519
Fax (618) 590-8199
Mailing address
403 Glen Carbon Rd
Glen Carbon, IL 62034-2965
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Specialist Primary | 174400000X | None listed |
| Family Medicine Physician | 207Q00000X | None listed |
Specialist: An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
Another provider at this address
Other specialist providers in Edwardsville
About NPI 1922796408
Fulfilling Life PLLC's National Provider Identifier is 1922796408, issued on Apr 24, 2023. The primary taxonomy on file is Specialist (174400000X), and the practice location is in Edwardsville, IL. The record was last updated on Apr 24, 2023.