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
ZIP Code
92571-7345
Phone
(951) 943-0869

Specialties & Taxonomy Codes

Specialty
Contractor

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