Individual
MRS. NANCY ALYCE FULTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
35 THE BOULEVARD, SAINT LOUIS, MO 63117
(314) 494-9322
Mailing address
8 UNIVERSAL DRIVE, ST. PETERS, MO 63376
(314) 494-9322
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2003031204
MO
Other
Enumeration date
10/31/2014
Last updated
10/31/2014
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