NPI 1053158253 · live from the CMS NPI Registry
Kurt Michael Russell
Massage Therapist in Long Beach, MS. National Provider Identifier 1053158253, active.
NPI record
| NPI | 1053158253 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 98 Jeff Davis Ave Ste B, Long Beach, MS 39560 |
| Practice phone | 228-313-9208 |
| Mailing address | 22 Ryan Cir, Long Beach, MS 39560 |
| Enumerated | July 15, 2024 |
| Last updated | July 15, 2024 |
| Sole proprietor | No |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 3806 (MS) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.