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1457820631
EVANDER CONZEL RUSS
GENEVA, NY
NPI
1457820631
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
164W00000X Licensed Practical Nurse
(Licence: NY 334018)
Enumeration Date
2018-11-17
Last Update Date
2018-11-17
Business Address
EVANDER CONZEL RUSS LPN
23 NORTH AVE
GENEVA, NY 14456-1127
Phone number: 585-438-1089
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Mailing Address
EVANDER CONZEL RUSS LPN
23 NORTH AVE
GENEVA, NY 14456-1127
Phone number: 585-438-1089
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