Organization
SEAN RUSSELL, O.M.D., PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SEAN RUSSELL O.M.D. (OWNER)
(702) 596-9595
Entity
Organization
Contact information
Practice address
129 W LAKE MEAD PKWY STE 2, HENDERSON, NV 89015-7055
(702) 564-6712
Mailing address
5621 RAVEN HORSE DR, LAS VEGAS, NV 89131-2070
(702) 596-9595
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
1042
NV
Other
Enumeration date
05/20/2013
Last updated
05/20/2013
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