Individual
MARK PAULUS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3847 PINE GROVE AVE, SUITE B, FORT GRATIOT, MI 48059-4265
(810) 984-2250
Mailing address
2028 MILITARY ST, PORT HURON, MI 48060-5971
(810) 931-3372
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
08/17/2006
Last updated
07/08/2007
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