National Provider Identifier
Michael Clarence Russ, LMT
Michael Clarence Russ, LMT is listed in the NPPES registry with a primary specialty of Massage Therapist in Depew, NY and a listed phone number of (716) 341-5152.
Profile Overview
- NPI
- 1487895116
- Provider Type
- Individual
- Primary Specialty
- Massage Therapist
- Enumeration Date
- March 09, 2009
- Last Updated
- March 09, 2009
Practice Location
- 5102 Transit RD
- Depew, NY 14043-4465
Phone: (716) 341-5152
Mailing Address
- 78 Southpoint Dr
- Lancaster, NY 14086-3334
Specialties
- Massage Therapist (225700000X)
Full Record
- NPI
- 1487895116
- Entity Type
- Individual
- Last Name
- Russ
- First Name
- Michael
- Middle Name
- Clarence
- Name Prefix
- Mr.
- Credential
- LMT
- Mailing Street Address
- 78 Southpoint Dr
- Mailing City
- Lancaster
- Mailing State
- NY
- Mailing ZIP Code
- 14086-3334
- Mailing Country
- US
- Mailing Phone
- (716) 341-5152
- Practice Street Address
- 5102 Transit RD
- Practice City
- Depew
- Practice State
- NY
- Practice ZIP Code
- 14043-4465
- Practice Country
- US
- Practice Phone
- (716) 341-5152
- Enumeration Date
- March 09, 2009
- Last Updated
- March 09, 2009
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- Massage Therapist (225700000X)