Individual
MICHAEL SHANE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
403 N SIXTH STREET, STE 8 AND STE 9, WEST MONROE, LA 71291
(318) 303-6142
(318) 855-8453
Mailing address
3517 PEGRAM CIR, MONROE, LA 71201-2159
(504) 583-0822
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
1616
LA
Other
Enumeration date
05/01/2023
Last updated
05/01/2023
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