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1194905257
KEVIN JOSEPH RUSSELL
MESA, AZ
NPI
1194905257
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
152W00000X Optometrist
(Licence: AZ 779)
Enumeration Date
2007-11-06
Last Update Date
2018-04-24
Business Address
Dr. KEVIN JOSEPH RUSSELL o.d.
2048 E. BASELINE RD. SUITE C6
MESA, AZ 85204
Phone number: 480-245-8929
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Mailing Address
Dr. KEVIN JOSEPH RUSSELL o.d.
23490 S. 201ST ST.
QUEEN CREEK, AZ 85142
Phone number: 480-245-8929
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