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1215408810
KATHERINE S FULLER
GRAND RAPIDS, MI
NPI
1215408810
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
225100000X Physical Therapist
(Licence: MI 5501004792)
Enumeration Date
2018-12-09
Last Update Date
2018-12-09
Business Address
KATHERINE S FULLER
1700 LEONARD ST NE
GRAND RAPIDS, MI 49505-5636
Phone number: 616-456-7243
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Mailing Address
KATHERINE S FULLER
2461 BLACK HORSE DR NE # NI
GRAND RAPIDS, MI 49505-3969
Phone number:
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