RUSSELL ADAM LEE

QUINCY, IL
NPI1174018618
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: IL  096.003331)
Enumeration Date2018-06-27
Last Update Date2018-06-27
Business Address
RUSSELL ADAM LEE ATC
1118 HAMPSHIRE ST
QUINCY, IL 62301-3027
Phone number: 212-222-6550
Mailing Address
RUSSELL ADAM LEE ATC
1118 HAMPSHIRE ST
QUINCY, IL 62301-3027
Phone number: 212-222-6550
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