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1588254197
RUSSELL LEE SUTHERLAND
KENOVA, WV
NPI
1588254197
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
3747P1801X Technician, Personal Care Attendant
Enumeration Date
2021-01-19
Last Update Date
2021-01-19
Business Address
RUSSELL LEE SUTHERLAND
820 POPLAR ST
KENOVA, WV 25530-1530
Phone number: 304-453-4992
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Mailing Address
RUSSELL LEE SUTHERLAND
820 POPLAR ST
KENOVA, WV 25530-1530
Phone number: 304-453-4992
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