Jerry Wallace Fulford
Jerry Wallace Fulford is a Massage Therapist in Capitola, California. Licensed in California. Registered with an NPI since 2018.
- Licensed in
- CA
- In the registry since
- 2018
Practice location Address checks out
4170 Gross Rd Ext Ste 6Capitola, CA 95010
Phone: (831) 464-1605
Show map & directions
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Massage Therapist (primary) | Taxonomy 225700000X · Licence 75622 (CA) |
|---|
Record details
| NPI number | 1427547355 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | No |
| NPI enumerated | May 7, 2018 |
| Last updated in NPPES | May 7, 2018 |
| Mailing address | 4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010 |
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