Individual
SHELBY RUSSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
UNIVERSITY OF TENNESSEE HEALTH SCIENCES CENTER, MEMPHIS, TN 38163-0001
(901) 448-5056
Mailing address
10053 GOSLING CIR S APT 203, CORDOVA, TN 38016-1799
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
10/18/2023
Last updated
10/18/2023
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