NPI 1164868006

Sean Russell, O.M.D., PLLC

Organisation Acupuncturist Henderson, NV

Practice location

Address: 129 W Lake Mead Pkwy STE 2, Henderson, NV 89015-7055
Phone: (702) 564-6712
Mailing address: 5621 Raven Horse Dr, Las Vegas, NV 89131-2070

Authorised official

Name: Sean Russell
Title: Owner
Phone: (702) 596-9595

Registered specialties

Acupuncturist Primary

Other Service Providers Taxonomy 171100000X Licence 1042 (NV)

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Registry record

NPI: 1164868006
Entity type: Organization
NPI issued: 20 May 2013
Record last updated: 20 May 2013

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.