Individual
RUSSELL THOMAS MORTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
522 N CURTIS AVE, PEA RIDGE, AR 72751-3817
(479) 451-9200
Mailing address
522 N CURTIS AVE, PEA RIDGE, AR 72751-3817
(479) 451-9200
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
16002
AR
Other
Enumeration date
01/08/2019
Last updated
01/08/2019
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