Individual
MR. RUSSELL WALLIS BUCK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMT
Contact information
Practice address
85 HARTLAND ST, STRATFORD, CT 06615-7617
(203) 380-8403
Mailing address
85 HARTLAND ST, STRATFORD, CT 06615-7617
(203) 380-8403
Taxonomy
Speciality
Code
Description
License number
State
225700000X
Massage Therapist
Primary
004311
CT
Other
Enumeration date
02/24/2008
Last updated
02/24/2008
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