Individual
MS. MELISSA LANE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AU.D.
Contact information
Practice address
502 MADISON OAK DR, SUITE 140, SAN ANTONIO, TX 78258-4084
(210) 647-3838
(210) 403-3166
Mailing address
1534 PALMER VW, SUITE 140, SAN ANTONIO, TX 78260-7218
(334) 391-7638
(334) 391-7638
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
80129
TX
Other
Enumeration date
01/10/2012
Last updated
12/21/2016
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