Individual
MYESHA FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMT
Contact information
Practice address
8725 LA TIJERA BLVD, LOS ANGELES, CA 90045-3906
(424) 331-5661
Mailing address
8725 LA TIJERA BLVD, LOS ANGELES, CA 90045-3906
(424) 331-5661
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
40742
CA
Other
Enumeration date
11/14/2019
Last updated
11/14/2019
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