Individual
KEVIN ANDREW FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
77 ALLEN ST, ASHEVILLE, NC 28806-3356
(661) 204-5415
Mailing address
77 ALLEN ST, ASHEVILLE, NC 28806-3356
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
16989
NC
225700000X
Massage Therapist
75728
CA
Other
Enumeration date
02/07/2022
Last updated
02/07/2022
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