Individual
HOLLY THULL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CPNP-PC
Contact information
Practice address
15902 PRINCETON CT, FRASER, MI 48026-4745
(586) 871-0485
Mailing address
15902 PRINCETON CT, FRASER, MI 48026-4745
(586) 871-0485
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
202019222
MI
Other
Enumeration date
07/04/2021
Last updated
07/04/2021
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