Individual
NIYOTA PULLIAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2711 MANFORD ST, FORT WAYNE, IN 46806-3923
(260) 702-7499
Mailing address
2711 MANFORD ST, FORT WAYNE, IN 46806-3923
(260) 702-7499
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
IN
Other
Enumeration date
08/31/2023
Last updated
09/15/2023
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