# MARCUS MITCHELL FULLER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1780157040
- **Gender:** Man
- **Credential:** LAC , LMT, MACOM

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 138929 | AK | — |
| 171100000X | Acupuncturist | MED-ACU-LIC-70143 | MT | Yes |

## Other

- **Enumeration date:** 01/09/2019
- **Last updated:** 01/09/2019