Lakila Tierra Fuller

NPI #1679920748 in Inkster, Michigan

Provider Information

NPI Number: 1679920748
Entity Type: Individual
Name: Lakila Tierra Fuller
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Technician, Other
Enumeration Date: May 19, 2016
Last Updated: May 19, 2016

Practice Location

Address: 26431 PRINCETON ST
City: Inkster
State: Michigan
ZIP Code: 48141-2444
Phone: (313) 207-8034

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Technician, Other	247200000X	Primary

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