ERA RUSSELL

LAGRANGE, GA
NPI1447604178
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy224P00000X Prosthetist
(Licence: GA  224p00000x)
Additional Taxonomies225000000X Orthotic Fitter
Enumeration Date2016-04-19
Last Update Date2021-11-01
Business Address
ERA RUSSELL Hair Loss Specialist
2170 W POINT RD SUITE 36
LAGRANGE, GA 30240-4007
Phone number: 762-323-7874
Mailing Address
ERA RUSSELL Hair Loss Specialist
2170 W POINT RD SUITE 36
LAGRANGE, GA 30240-4007
Phone number: 762-323-7874