Russell Ivan Kimball, LMT

NPI #1497390942 in Aberdeen, South Dakota

Provider Information

NPI Number: 1497390942
Entity Type: Individual
Name: Russell Ivan Kimball, LMT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Massage Therapist
Credential: LMT
Enumeration Date: Nov 7, 2019
Last Updated: Nov 7, 2019

Practice Location

Address: 202 S MAIN ST STE 450
City: Aberdeen
State: South Dakota
ZIP Code: 57401-4114
Phone: (605) 377-5930

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Massage Therapist	225700000X	Primary

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