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Ivory Fuller
NPI 1326465048 · on the registry since 2014 · sole proprietor
Practice
- Address
- 29100 Lorikay St
Farmington Hills, MI 48334 - Phone
- (313) 772-0027
Registry record
- Primary taxonomy
- 237700000X
237700000X
- Also registered as
- 231H00000X
237600000X - Licence states on file
- MI
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-03-19
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