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1255042826
IVORY RUSS
ST AUGUSTINE, FL
NPI
1255042826
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
251E00000X Home Health
(Licence: FL 31101007)
Enumeration Date
2022-12-05
Last Update Date
2023-01-30
Business Address
IVORY RUSS
300 SUMMER BREEZE WAY APT 1106
ST AUGUSTINE, FL 32086-1804
Phone number: 912-342-9829
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Mailing Address
IVORY RUSS
300 SUMMER BREEZE WAY APT 1106
ST AUGUSTINE, FL 32086-1804
Phone number: 912-342-9829
Copy
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