Individual
LORRAINE ELIZABETH RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
2001 PEACHTREE RD NE, SUITE 100, ATLANTA, GA 30309-1476
(404) 605-1982
Mailing address
2001 PEACHTREE RD NE, SUITE 100, ATLANTA, GA 30309-1476
(404) 605-1982
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT000518
GA
Other
Enumeration date
08/31/2010
Last updated
08/31/2010
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