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Individual

JAMIE GORDON RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2005 OAK RIVER ST, LAS VEGAS, NV 89134-6706
(702) 279-8124
Mailing address
2005 OAK RIVER ST, LAS VEGAS, NV 89134-6706
(702) 279-8124

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
15-0541
NV

Other

Enumeration date
09/22/2016
Last updated
09/22/2016
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