Individual
MRS. PHYLLIS RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
407 E MONTGOMERY XRD, SAVANNAH, GA 31406-4980
(912) 925-0881
Mailing address
407 E MONTGOMERY XRD, SAVANNAH, GA 31406-4980
(912) 925-0881
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
MT009487
GA
Other
Enumeration date
02/14/2014
Last updated
02/14/2014
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