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1326196593
RICHARD DEWAYNE RUSSELL
CONWAY, AR
NPI
1326196593
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
332B00000X Durable Medical Equipment & Medical Supplies
(Licence: AR MG00708)
Enumeration Date
2007-01-06
Last Update Date
2007-07-09
Business Address
MR. RICHARD DEWAYNE RUSSELL
3165 BOONE DR
CONWAY, AR 72034-7388
Phone number: 501-504-2126
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Mailing Address
MR. RICHARD DEWAYNE RUSSELL
3165 BOONE DR
CONWAY, AR 72034-7388
Phone number: 501-504-2126
Copy
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