FATIA A RUSSELL

FAYETTEVILLE, NC
NPI1356843379
Entity TypeIndividual
GenderFemale
Sole Proprietor ?Yes
Primary Taxonomy224P00000X Prosthetist
(Licence: NC  108796)
Enumeration Date2018-03-06
Last Update Date2019-08-31
Business Address
FATIA A RUSSELL
6245 LAKEHAVEN DR
FAYETTEVILLE, NC 28304-0610
Phone number: 910-479-6214
Mailing Address
FATIA A RUSSELL
6245 LAKEHAVEN DR
FAYETTEVILLE, NC 28304-0610
Phone number: 910-479-6214