| Jerry Wallace Fulford, | |
|
4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010 | |
| (831) 464-1605 | |
| Not Available |
| Full Name | Jerry Wallace Fulford |
|---|---|
| Gender | Male |
| Speciality | Massage Therapist |
| Location | 4170 Gross Rd. Extension, Capitola, California |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427547355 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 225700000X | Massage Therapist | 75622 (California) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Jerry Wallace Fulford, 4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010 Ph: () - | Jerry Wallace Fulford, 4170 Gross Rd. Extension, Suite 6, Capitola, CA 95010 Ph: (831) 464-1605 |
Ms. Diana Grey, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 240 Monterey Ave Apt 4, Capitola, CA 95010 Phone: 831-402-0505 | |
Alex Junya Wayama, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 1485 45th Ave Apt 1, Capitola, CA 95010 Phone: 831-600-5162 | |
David William Fournier, Massage Therapist Medicare: Not Enrolled in Medicare Practice Location: 4895 Capitola Rd, Capitola, CA 95010 Phone: 831-345-3763 |