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Individual
DR. MARK DALE RUSSELL
Active
Individual
DR. MARK DALE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
1894
NM
111N00000X
Chiropractor
2622
OK
111N00000X
Chiropractor
Primary
5912
TX
111N00000X
Chiropractor
928
MT
Other
Enumeration date
07/07/2005
Last updated
04/01/2014
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