Individual
MR. RUSSELL JOHN DESHAIES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OTR
Contact information
Practice address
841 MERRIMACK ST, LOWELL, MA 01854-3500
(978) 459-0546
Mailing address
841 MERRIMACK ST, LOWELL, MA 01854-3500
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
11544
MA
Other
Enumeration date
04/26/2015
Last updated
04/26/2015
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