ROBERTA D RUSSELL

CAMP VERDE, AZ
NPI1962782979
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy172M00000X Mechanotherapist
(Licence: AZ  MT-04916)
Enumeration Date2011-08-22
Last Update Date2011-08-22
Business Address
-- ROBERTA D RUSSELL LMT
3964 W SHEA LN
CAMP VERDE, AZ 86322-8530
Phone number: 928-451-2588
Mailing Address
-- ROBERTA D RUSSELL LMT
3964 W SHEA LN
CAMP VERDE, AZ 86322-8530
Phone number: 928-451-2588