Provider Demographics
NPI:1659665719
Name:HERRING, RUSSELL DAVID (DC)
Entity type:Individual
Prefix:DR
First Name:RUSSELL
Middle Name:DAVID
Last Name:HERRING
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:OPELIKA
Mailing Address - State:AL
Mailing Address - Zip Code:36801-9703
Mailing Address - Country:US
Mailing Address - Phone:334-744-0857
Mailing Address - Fax:
Practice Address - Street 1:1103 ANDREWS RD
Practice Address - Street 2:
Practice Address - City:OPELIKA
Practice Address - State:AL
Practice Address - Zip Code:36801-9703
Practice Address - Country:US
Practice Address - Phone:334-744-0857
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-06-07
Last Update Date:2011-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL2336111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor