Individual provider · Type 1 NPI
Mark A. Fuller
Taxi · Peoria, IL
NPI number
1417470147
Active
Practice location
2215 W Willow Knolls Drive, Apt 503A
Peoria, IL 61614-1446
Mailing address
2215 W Willow Knolls Dr Apt 503A
Peoria, IL 61614-1446
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Taxi Primary | 344600000X | None listed |
Taxi: A land commercial vehicle used for the transporting of persons in non-emergency situations. The vehicle meets local, county or state regulations set forth by the jurisdictions where it is located.
About NPI 1417470147
Mark A. Fuller's National Provider Identifier is 1417470147, issued on Jul 25, 2017. The primary taxonomy on file is Taxi (344600000X), and the practice location is in Peoria, IL. The record was last updated on Jul 21, 2022.