Search › Michigan › 175T00000X
Kenneth Fultz, CPRM
NPI 1023574787 · on the registry since 2019
Practice
- Address
- 15941 Fairfield St
Detroit, MI 48238 - Phone
- (313) 345-4310
- Fax
- (313) 345-4315
- Organisation at this address
- Lakeridge Village, Inc.
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 24
Registry record
- Primary taxonomy
- 175T00000X
175T00000X
- Sex
- Male
- Record last updated
- 2019-02-18
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Michigan