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1437103306
GARY D. RUSSELL
PHOENIX, AZ
NPI
1437103306
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: AZ 1136)
Enumeration Date
2006-05-22
Last Update Date
2007-07-08
Business Address
-- GARY D. RUSSELL P.A.-C
2525 E ROOSEVELT ST
PHOENIX, AZ 85008-4948
Phone number: 602-344-5651
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Mailing Address
-- GARY D. RUSSELL P.A.-C
PO BOX 5177
PHOENIX, AZ 85010-5177
Phone number: 602-344-5651
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