NPI 1053158253

Kurt Michael Russell

Practitioner Massage Therapist Long Beach, MS

Practice location

Address: 98 Jeff Davis Ave STE B, Long Beach, MS 39560-6172
Phone: (228) 313-9208
Mailing address: 22 Ryan Cir, Long Beach, MS 39560-2313

Registered specialties

Massage Therapist Primary

Respiratory, Developmental, Rehabilitative and Restorative Service Providers Taxonomy 225700000X Licence 3806 (MS)

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Registry record

NPI: 1053158253
Entity type: Individual
Sex (as registered): Male
NPI issued: 15 Jul 2024
Record last updated: 15 Jul 2024

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.