Individual
LAURA RENEE FULTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RD, LD
Contact information
Practice address
12303 DE PAUL DR, BRIDGETON, MO 63044-2512
(314) 344-6373
Mailing address
5028 S 37TH ST, SAINT LOUIS, MO 63116-4134
(314) 503-9556
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
—
—
Other
Enumeration date
08/01/2019
Last updated
08/01/2019
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