RICHARD DEWAYNE RUSSELL

CONWAY, AR
NPI1326196593
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy332B00000X Durable Medical Equipment & Medical Supplies
(Licence: AR  MG00708)
Enumeration Date2007-01-06
Last Update Date2007-07-09
Business Address
Mr. RICHARD DEWAYNE RUSSELL
3165 BOONE DR
CONWAY, AR 72034-7388
Phone number: 501-504-2126
Mailing Address
Mr. RICHARD DEWAYNE RUSSELL
3165 BOONE DR
CONWAY, AR 72034-7388
Phone number: 501-504-2126
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