Individual provider · Type 1 NPI

Terisa Bay Russell, LMT

Massage Therapist · Maitland, FL

NPI number 1194020065 Active

Practice location

110 N Orlando Ave
Maitland, FL 32751-5574

Call (407) 324-6454 Map

Mailing address

2836 Hunt Club Ln
Orlando, FL 32826-3912

Specialties and licenses

TaxonomyCodeLicense
Massage Therapist Primary 225700000XMA42761 (FL)

Massage Therapist: An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes.

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About NPI 1194020065

Terisa Bay Russell, LMT's National Provider Identifier is 1194020065, issued on Jan 24, 2011. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Maitland, FL. The record was last updated on Apr 19, 2011.