Organization
RUSSELL CHIROPRACTIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS ALAN RUSSELL D.C. (DR. OF CHIROPRACTIC)
(314) 604-5761
Entity
Organization
Contact information
Practice address
2161 W TERRA LN, O FALLON, MO 63366-2366
(636) 887-9003
(636) 327-6090
Mailing address
2161 W TERRA LN, O FALLON, MO 63366-2366
(636) 887-9003
(636) 327-6090
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2008002546
MO
Other
Enumeration date
11/06/2008
Last updated
11/06/2008
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