Provider Demographics
NPI:1417118704
Name:GULICK, LAURIE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:MARIE
Last Name:GULICK
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3413 WOODS EDGE
Mailing Address - Street 2:
Mailing Address - City:OKEMOS
Mailing Address - State:MI
Mailing Address - Zip Code:48864-5901
Mailing Address - Country:US
Mailing Address - Phone:517-349-3303
Mailing Address - Fax:517-349-4374
Practice Address - Street 1:2510 LAKE LANSING RD
Practice Address - Street 2:
Practice Address - City:LANSING
Practice Address - State:MI
Practice Address - Zip Code:48912-5669
Practice Address - Country:US
Practice Address - Phone:517-853-0781
Practice Address - Fax:517-908-0751
Is Sole Proprietor?:No
Enumeration Date:2008-06-19
Last Update Date:2016-03-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI5101017741207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine