Individual
MRS. JENNIFER C RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
400 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-5760
(716) 631-1516
(716) 204-2998
Mailing address
400 INTERNATIONAL DR, WILLIAMSVILLE, NY 14221-5760
(716) 631-1516
(716) 204-2998
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
009520-1
NY
Other
Enumeration date
02/17/2009
Last updated
02/17/2009
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