Individual
KURT MICHAEL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
98 JEFF DAVIS AVE STE B, LONG BEACH, MS 39560-6172
(228) 313-9208
Mailing address
22 RYAN CIR, LONG BEACH, MS 39560-2313
(601) 549-4098
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
3806
MS
Other
Enumeration date
07/15/2024
Last updated
07/15/2024
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