Individual
ROBERT WAYNE FULLER JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
7211 NW 83RD ST STE 207D, KANSAS CITY, MO 64152-6022
(816) 482-1695
Mailing address
955 STARFALL DR, CEDARCREEK, MO 65627-4203
(660) 270-4048
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2005017920
MO
Other
Enumeration date
10/22/2020
Last updated
06/03/2025
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