Individual
MISS CONSTANCE S FULK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
L.M.P.
Contact information
Practice address
2821 E 27TH AVE, SPOKANE, WA 99223-4914
(509) 532-8607
Mailing address
4120 E 11TH AVE, SPOKANE, WA 99202-5325
(509) 532-8607
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MA00018056
WA
Other
Enumeration date
09/18/2007
Last updated
09/25/2007
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