NPI 1013303296 · live from the CMS NPI Registry
Charlene Russell, LMT
Mechanotherapist in Vancleave, MS. National Provider Identifier 1013303296, active.
NPI record
| NPI | 1013303296 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Mechanotherapist 172M00000X |
| Practice location | 12603 Highway 57, Vancleave, MS 39565 |
| Practice phone | 228-283-5083 |
| Mailing address | Po Box 5667, Vancleave, MS 39565 |
| Enumerated | April 14, 2015 |
| Last updated | April 14, 2015 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Mechanotherapist primary | 172M00000X | 35 (MS) |
| Massage Therapist | 225700000X | 35 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.