Individual
MRS. FELICIA RAQUEL FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
741 ERIKA LN, GROVETOWN, GA 30813-8305
(910) 551-9435
Mailing address
741 ERIKA LN, GROVETOWN, GA 30813-8305
(910) 551-9435
Taxonomy
Speciality
Code
Description
License number
State
225800000X
Recreation Therapist
Primary
—
—
Other
Enumeration date
04/27/2016
Last updated
04/27/2016
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