CHARLENE RUSSELL

VANCLEAVE, MS
NPI1013303296
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy172M00000X Mechanotherapist
(Licence: MS  35)
Additional Taxonomies225700000X Massage Therapist
(Licence: MS  35)
Enumeration Date2015-04-14
Last Update Date2015-04-14
Business Address
-- CHARLENE RUSSELL LMT
12603 HIGHWAY 57
VANCLEAVE, MS 39565-7420
Phone number: 228-283-5083
Mailing Address
-- CHARLENE RUSSELL LMT
PO BOX 5667
VANCLEAVE, MS 39565-5667
Phone number: 228-283-5083
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