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Individual

MR. CLIFFORD WARREN FULTON I

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
L.M.T.

Contact information

Practice address
1200 WEST VIRGINIA AVE, CLARKSBURG, WV 26301-1953
(304) 326-3300
Mailing address
RR 4 BOX 546, SALEM, WV 26426-8910
(304) 844-6063

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
WV

Other

Enumeration date
09/06/2008
Last updated
09/06/2008
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