MS. La Shawn Nichole Russell
NPI #1194157826 in Perris, California
Provider Information
- NPI Number
- 1194157826
- Entity Type
- Individual
- Name
- MS. La Shawn Nichole Russell
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Contractor
- Enumeration Date
- Aug 5, 2013
- Last Updated
- Aug 5, 2013
Practice Location
- Address
- 3503 CROMWELL CT
- City
- Perris
- State
- California
- ZIP Code
- 92571-7345
- Phone
- (951) 943-0869
Specialties & Taxonomy Codes
| Specialty |
|---|
| Contractor |
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