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Russell Pen Gaines, LMT
Massage Therapist in Destin, Florida
NPI 1639371008

Russell Pen Gaines is a Massage Therapist based in Shalimar, FL. Russell Pen Gaines practices in Destin, FL and has the professional credentials of LMT. The NPI Number for Russell Pen Gaines is 1639371008 and holds a License No. MA18637 (Florida).

The current practice location address for Russell Pen Gaines is 3999 Commons Dr W, Destin, FL and can be reached out via phone at 850-837-9552.

Location: 3999 Commons Dr W, Destin, FL, 32579
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1639371008
Provider Name
Russell Pen Gaines
Credential
LMT
Provider Entity Type
Individual
Gender
Male
Address
3999 Commons Dr W, Destin, FL, 32579
Phone Number
850-837-9552
Fax Number
Provider Enumeration Date
06/05/2007
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
3999 Commons Dr W
City
Destin
State
Florida
Zip
32541
Phone Number
850-837-9552
Fax Number
person
Provider Business Mailing Address Details
Address
3999 Commons Dr W
City
Destin
State
Florida
Zip
32541
Phone Number
850-837-9552
Fax Number
person
Provider's Taxonomy Details 1
Type
Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification
Massage Therapist
Speciality
-
Taxonomy
225700000X
License No.
MA18637 (Florida)
Definition
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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