| NPI | 1639110182 |
|---|---|
| Other Name | KIMBERLY CAROL RUSS |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | |
| Primary Taxonomy | 111N00000X Chiropractor (Licence: AL 2138) |
| Additional Taxonomies | 111N00000X Chiropractor (Licence: SC 2997) |
| Enumeration Date | 2006-06-08 |
| Last Update Date | 2007-07-08 |