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1487895116
MICHAEL CLARENCE RUSS
DEPEW, NY
NPI
1487895116
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
225700000X Massage Therapist
(Licence: NY 022275)
Enumeration Date
2009-03-09
Last Update Date
2009-03-09
Business Address
Mr. MICHAEL CLARENCE RUSS LMT
5102 TRANSIT RD
DEPEW, NY 14043-4465
Phone number: 716-341-5152
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Mailing Address
Mr. MICHAEL CLARENCE RUSS LMT
78 SOUTHPOINT DR
LANCASTER, NY 14086-3334
Phone number: 716-341-5152
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