NPI 1376011171 · live from the CMS NPI Registry
Purnell Russell, LMT
Massage Therapist in Fort Washington, MD. National Provider Identifier 1376011171, active.
NPI record
| NPI | 1376011171 Type 1 · individual |
|---|---|
| Status | Active |
| Primary specialty | Massage Therapist 225700000X |
| Practice location | 8507 Oxon Hill Rd Ste 200-33, Fort Washington, MD 20744 |
| Practice phone | 202-246-6601 |
| Mailing address | 2707 Shipley Ter Se Apt 2, Washington, DC 20020 |
| Enumerated | November 9, 2018 |
| Last updated | November 9, 2018 |
| Sole proprietor | Yes |
Taxonomies and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist primary | 225700000X | 0019015297 (VA) |
Source: CMS NPPES NPI Registry. NPI data is self-reported by providers; license numbers are not verified by CMS.