Individual
SHUNETHY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
72 OLD NEW BRUNSWICK RD, 2, PISCATAWAY, NJ 08854-3885
(908) 868-7380
Mailing address
72 OLD NEW BRUNSWICK RD, APT 2, PISCATAWAY, NJ 08854
(908) 868-7380
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
18KT00447100
NJ
Other
Enumeration date
05/06/2014
Last updated
05/06/2014
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