Individual provider · Type 1 NPI
Purnell Russell, LMT
Massage Therapist · Fort Washington, MD
NPI number
1376011171
Active
Practice location
8507 Oxon Hill Rd Ste 200-33
Fort Washington, MD 20744-4766
Mailing address
2707 Shipley Ter SE Apt 2
Washington, DC 20020-1823
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Massage Therapist Primary | 225700000X | 0019015297 (VA) |
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 1376011171
Purnell Russell, LMT's National Provider Identifier is 1376011171, issued on Nov 9, 2018. The primary taxonomy on file is Massage Therapist (225700000X), and the practice location is in Fort Washington, MD. The record was last updated on Nov 9, 2018.