MARK DUANE RUSSELL

SAINT JOSEPH, MI
NPI1306867049
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy2255A2300X Specialist/Technologist, Athletic Trainer
Enumeration Date2006-07-21
Last Update Date2007-07-08
Business Address
-- MARK DUANE RUSSELL ATC, CSCS
3950 HOLLYWOOD RD STE 140
SAINT JOSEPH, MI 49085-9151
Phone number: 269-556-7150
Mailing Address
-- MARK DUANE RUSSELL ATC, CSCS
4858 SADLER DR
WATERVLIET, MI 49098-8703
Phone number: 269-463-5859