RUSSELL LEE SHORT

WILMINGTON, NC
NPI1336355239
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2007-05-15
Last Update Date2007-07-08
Business Address
-- RUSSELL LEE SHORT IDC
7513 BRITTANY LAKES DR
WILMINGTON, NC 28411
Phone number: 910-541-5341
Mailing Address
-- RUSSELL LEE SHORT IDC
7513 BRITTANY LAKES DR
WILMINGTON, NC 28411
Phone number: 910-541-5341
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