Individual
KILA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3818 S LEE HWY, MC DONALD, TN 37353-5876
(423) 320-7794
Mailing address
3818 S LEE HWY, MC DONALD, TN 37353-5876
(423) 320-7794
Taxonomy
Speciality
Code
Description
License number
State
224P00000X
Prosthetist
Primary
—
TN
224P00000X
Prosthetist
—
—
Other
Enumeration date
02/13/2022
Last updated
02/13/2022
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