Individual
RENNY BEAU RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
6624 ROYAL ST, PLEASANT VALLEY, MO 64068-8711
(816) 824-9690
Mailing address
8009 NE 105TH TER, KANSAS CITY, MO 64157-9100
(816) 824-9690
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2008015663
MO
111N00000X
Chiropractor
3841
OK
Other
Enumeration date
10/12/2006
Last updated
04/16/2024
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