Individual
DAWN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
4839 W OAK DR, NEW PALESTINE, IN 46163-9648
(317) 525-5707
Mailing address
4839 W OAK DR, NEW PALESTINE, IN 46163-9648
(317) 525-5707
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT21003734
IN
Other
Enumeration date
12/10/2019
Last updated
01/05/2020
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