Individual
CARLY ELIZABETH CRULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
44405 WOODWARD AVE, PONTIAC, MI 48341-5023
(248) 858-3000
Mailing address
3430 FARMERS CREEK RD, METAMORA, MI 48455-9791
Taxonomy
Speciality
Code
Description
License number
State
363LP2300X
Primary Care Nurse Practitioner
Primary
4704291722
MI
Other
Enumeration date
03/03/2019
Last updated
03/03/2019
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