Michele Russell

NPI #1346056918 in Goreville, Illinois

Provider Information

NPI Number: 1346056918
Entity Type: Individual
Name: Michele Russell
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Enumeration Date: Dec 9, 2024
Last Updated: Dec 9, 2024

Practice Location

Address: 7655 TUNNEL HILL RD
City: Goreville
State: Illinois
ZIP Code: 62939-2820
Phone: (618) 926-2456

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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