Individual
DAMON FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
89 5TH AVE STE 306, NEW YORK, NY 10003-3020
(347) 772-7810
Mailing address
829 LAFAYETTE AVE APT 4A, BROOKLYN, NY 11221-1979
(347) 772-7810
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
030137
NY
Other
Enumeration date
01/29/2024
Last updated
01/29/2024
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