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1578614194
WILLIAM L RUSSELBURG
PADUCAH, KY
NPI
1578614194
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center)
Enumeration Date
2007-01-12
Last Update Date
2009-02-24
Business Address
-- WILLIAM L RUSSELBURG
425 BROADWAY ST
PADUCAH, KY 42001-0713
Phone number: 270-442-7121
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Mailing Address
-- WILLIAM L RUSSELBURG
425 BROADWAY
PADUCAH, KY 42001
Phone number:
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