MR. Richard Dean Russ, LMT

NPI #1104040484 in Beaver, Pennsylvania

Provider Information

NPI Number: 1104040484
Entity Type: Individual
Name: MR. Richard Dean Russ, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Apr 11, 2007
Last Updated: Aug 27, 2007

Practice Location

Address: 971 3RD ST
City: Beaver
State: Pennsylvania
ZIP Code: 15009-2046
Phone: (724) 774-8470

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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