Individual
LATONYA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
27578 SCHOOLCRAFT RD, LIVONIA, MI 48150-2203
(734) 744-9667
(734) 744-9668
Mailing address
12829 LEVERNE, REDFORD, MI 48239-2732
(734) 744-9667
(734) 744-9668
Taxonomy
Speciality
Code
Description
License number
State
343900000X
Non-emergency Medical Transport (VAN)
Primary
—
—
Other
Enumeration date
03/11/2016
Last updated
03/11/2016
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