Individual
KRISTY FULKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
21 MALLARD CT, BECKLEY, WV 25801-3615
(304) 890-8020
Mailing address
21 MALLARD CT, BECKLEY, WV 25801-3615
(304) 890-8020
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
2013-3188
WV
Other
Enumeration date
08/10/2021
Last updated
08/10/2021
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