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1407085921
RUSSELL DAVID MAYNARD
CORBIN, KY
NPI
1407085921
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YM0800X Counselor, Mental Health
Enumeration Date
2009-07-06
Last Update Date
2009-07-06
Business Address
-- RUSSELL DAVID MAYNARD BA
1203 AMERICAN GREETING CARD RD
CORBIN, KY 40701-4811
Phone number: 606-528-7010
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Mailing Address
-- RUSSELL DAVID MAYNARD BA
PO BOX 568
CORBIN, KY 40702-0568
Phone number:
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