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1376897660
GREGORY S RUSSELL
FORT WAYNE, IN
NPI
1376897660
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: IN 26015397A)
Enumeration Date
2012-11-08
Last Update Date
2012-11-08
Business Address
Dr. GREGORY S RUSSELL Pharm.D
414 E DUPONT RD
FORT WAYNE, IN 46825-2050
Phone number: 260-490-3447
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Mailing Address
Dr. GREGORY S RUSSELL Pharm.D
414 E DUPONT RD
FORT WAYNE, IN 46825-2050
Phone number: 260-490-3447
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