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Individual

MR. RICHARD DEAN RUSS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMT

Contact information

Practice address
971 3RD ST, BEAVER, PA 15009-2046
(724) 774-8470
(724) 774-8471
Mailing address
150 MORTIMER LN, ALIQUIPPA, PA 15001-9497
(724) 375-2904

Taxonomy

Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
33007373
OH

Other

Enumeration date
04/11/2007
Last updated
08/27/2007
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