SearchMichigan237700000X

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