Individual
MELISSA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
9898 MAPLE AVE, HESPERIA, CA 92345-2968
(760) 244-9898
Mailing address
10785 ARROYO AVE, HESPERIA, CA 92345-2503
(916) 396-6306
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
2000003553
CA
Other
Enumeration date
07/01/2014
Last updated
07/01/2014
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