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Russell Kenworthy, ATC
NPI 1417362559 · on the registry since 2014 · sole proprietor
Practice
- Address
- 312 Rita Ln
Long Beach, MS 39560 - Phone
- (228) 234-4959
Registry record
- Primary taxonomy
- 2255A2300X
2255A2300X
- Licence states on file
- MS
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2014-06-27
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Mississippi