Individual
ERNESTO CARULLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1064 W HURON ST, WATERFORD, MI 48328-3730
(248) 681-5113
Mailing address
24152 SUSAN DR, FARMINGTON HILLS, MI 48336-2829
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
5501004076
MI
Other
Enumeration date
05/04/2007
Last updated
07/08/2007
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