Individual
CARLOS FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMBT# 11837
Contact information
Practice address
1406 BEATTIES FORD RD, CHARLOTTE, NC 28216-4550
(704) 492-6784
Mailing address
2401 ALLEGHANY ST, CHARLOTTE, NC 28208-3742
(704) 492-6784
Taxonomy
Speciality
Code
Description
License number
State
173C00000X
Reflexologist
Primary
LMBT# 11837
NC
Other
Enumeration date
07/12/2012
Last updated
07/12/2012
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