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1578777629
DALLAS GALE RUSSO
MADERA, CA
NPI
1578777629
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Former Name
DALLAS GALE BATES
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
163WP0808X Registered Nurse, Psych/Mental Health
(Licence: CA 461890)
Enumeration Date
2007-05-09
Last Update Date
2007-07-08
Business Address
Ms. DALLAS GALE RUSSO RN
14277 ROAD 28
MADERA, CA 93638-5715
Phone number: 559-673-3508
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Mailing Address
Ms. DALLAS GALE RUSSO RN
14277 ROAD 28 P.O. BOX 1288
MADERA, CA 93638-5715
Phone number: 559-673-3508
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