Individual
RACQUELL MONIQUE FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
5603 ARAPAHOE AVE STE 5, BOULDER, CO 80303-1377
(737) 255-2563
Mailing address
PO BOX 7412, BROOMFIELD, CO 80021-0024
(737) 255-2563
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT.0009580
CO
Other
Enumeration date
12/29/2023
Last updated
12/29/2023
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