Individual
JEFFREY FULLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3824 CEDAR SPRINGS RD # 433, DALLAS, TX 75219-4136
(214) 306-5401
(214) 206-9073
Mailing address
3824 CEDAR SPRINGS RD # 433, DALLAS, TX 75219-4136
(214) 306-5401
(214) 206-9073
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT032534
TX
Other
Enumeration date
10/16/2013
Last updated
10/16/2013
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