Individual
PATRICIA LYNN FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3554 WESTWOOD RD NE, MANCELONA, MI 49659-9539
(231) 676-9859
(231) 916-2347
Mailing address
3554 WESTWOOD RD NE, MANCELONA, MI 49659-9539
(231) 676-9859
(231) 916-2347
Taxonomy
Speciality
Code
Description
License number
State
251E00000X
Home Health Agency
Primary
802059811
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
802059811
AUTO CLAIMS
MI
Enumeration date
10/25/2019
Last updated
10/25/2019
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