# SEAN RUSSELL, O.M.D., PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1164868006
- **Authorized official:** DR. SEAN RUSSELL O.M.D. (OWNER)
- **Authorized official phone:** (702) 596-9595

## Contact information

- **Practice address:** 129 W LAKE MEAD PKWY STE 2, HENDERSON, NV 89015-7055
- **Practice address phone:** (702) 564-6712
- **Mailing address:** 5621 RAVEN HORSE DR, LAS VEGAS, NV 89131-2070
- **Mailing address phone:** (702) 596-9595

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 171100000X | Acupuncturist | 1042 | NV | Yes |

## Other

- **Enumeration date:** 05/20/2013
- **Last updated:** 05/20/2013