Individual
DAVID WILLIAM FOURNIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4895 CAPITOLA RD, CAPITOLA, CA 95010-3810
(831) 345-3763
Mailing address
690 37TH AVE APT B, SANTA CRUZ, CA 95062-5170
(831) 345-3763
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
72476
CA
Other
Enumeration date
09/28/2018
Last updated
09/28/2018
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