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1073936100
LATRECE RUSSELL
CHICAGO, IL
NPI
1073936100
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
247200000X Technician, Other
Enumeration Date
2014-01-24
Last Update Date
2014-01-24
Business Address
-- LATRECE RUSSELL
4734 S PRAIRIE AVE
CHICAGO, IL 60615-1206
Phone number: 708-252-1958
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Mailing Address
-- LATRECE RUSSELL
4734 S PRAIRIE AVE UNIT1
CHICAGO, IL 60615-1206
Phone number: 708-252-1958
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