Kim Russo, LMT

NPI #1487268306 in North Bellmore, New York

Provider Information

NPI Number: 1487268306
Entity Type: Individual
Name: Kim Russo, LMT
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Sep 8, 2020
Last Updated: Sep 8, 2020

Practice Location

Address: 2505 WASHINGTON BLVD
City: North Bellmore
State: New York
ZIP Code: 11710-2642
Phone: (516) 661-9877

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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