Individual
MICHELLE LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
800 PENNSYLVANIA AVENUE, CHILDREN'S MEDICINE CENTER, CHARLESTON, WV 25302
(304) 414-1880
(304) 414-1886
Mailing address
112 BEECHWOOD BLVD, PULASKI, PA 16143-9302
(724) 714-7625
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
04/18/2023
Last updated
04/18/2023
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