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1154986032
MILLIE D RUSSELL
NEWPORT, AR
NPI
1154986032
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2019-05-06
Last Update Date
2020-08-03
Business Address
MILLIE D RUSSELL
2005 MCLAIN ST
NEWPORT, AR 72112-3662
Phone number: 870-495-1990
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Mailing Address
MILLIE D RUSSELL
2809 FOREST HOME RD.
JONESBORO, AR 72401-8261
Phone number: 870-530-4414
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