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1700179199
RUSSELL ADAM BURNHAM
FORT DRUM, NY
NPI
1700179199
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
Enumeration Date
2011-05-18
Last Update Date
2012-08-30
Business Address
RUSSELL ADAM BURNHAM PA-C
P-10506 EUPHRATES RIVER VALLEY RD 1-89 CAV, 2BCT, 10TH MTN DIV
FORT DRUM, NY 13602-5438
Phone number: 315-774-0024
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Mailing Address
RUSSELL ADAM BURNHAM PA-C
P-10506 EUPHRATES RIVER VALLEY ROAD 1-89 CAV
FORT DRUM, NY 13601
Phone number: 315-774-0024
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