Lori Fullmer

NPI #1417407867 in White Lake, Michigan

Provider Information

NPI Number: 1417407867
Entity Type: Individual
Name: Lori Fullmer
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: Oct 10, 2016
Last Updated: Oct 10, 2016

Practice Location

Address: 251 RUSTIC CIR
City: White Lake
State: Michigan
ZIP Code: 48386-3041
Phone: (248) 672-7984

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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