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Individual

MR. LESTER LEON RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
10111 CAMERON RIDGE TRL, CORDOVA, TN 38016-7184
(901) 679-5366
Mailing address
810 WASHINGTON AVE APT 818, MEMPHIS, TN 38105-4559
(901) 679-5366

Taxonomy

Speciality
Code
Description
License number
State
146L00000X
Paramedic
34105
TN
225700000X
Massage Therapist
Primary
13023
TN

Other

Enumeration date
05/09/2014
Last updated
03/24/2021
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