Individual
LORI FULLMER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 RUSTIC CIR, WHITE LAKE, MI 48386-3041
(248) 672-7984
Mailing address
251 RUSTIC CIR, WHITE LAKE, MI 48386-3041
(248) 672-7984
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
MI
Other
Enumeration date
10/10/2016
Last updated
10/10/2016
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