Individual
DIANNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RMT
Contact information
Practice address
3938 JFK PKWY, SUITE F11, FORT COLLINS, CO 80525
(970) 204-0516
(970) 204-6812
Mailing address
3938 JFK PARKWAY, FORT COLLINS, CO 80525
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MT.0015078
CO
Other
Enumeration date
03/25/2014
Last updated
03/25/2014
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