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Individual
MARCUS MITCHELL FULLER
Active
Individual
MARCUS MITCHELL FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC , LMT, MACOM
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
138929
AK
171100000X
Acupuncturist
Primary
MED-ACU-LIC-70143
MT
Other
Enumeration date
01/09/2019
Last updated
01/09/2019
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