KENNETH LEE RUSSELL

CAMP LEJEUNE, NC
NPI1639661192
Professional NameN/A N/A N/A
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy1710I1002X Military Health Care Provider, Independent Duty Corpsman
Enumeration Date2018-05-31
Last Update Date2018-05-31
Business Address
Mr. KENNETH LEE RUSSELL NAVY SOIDC
3D MARINE RAIDER BATTALION
CAMP LEJEUNE, NC 28546
Phone number: 360-808-1590
Mailing Address
Mr. KENNETH LEE RUSSELL NAVY SOIDC
1101 MAREN CV APT 102
SNEADS FERRY, NC 28460-0080
Phone number: 360-808-1590
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