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1700398773
CODY M RUSSELL
IRONTON, OH
NPI
1700398773
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
(Licence: OH CDCA.166665)
Enumeration Date
2017-10-31
Last Update Date
2018-05-07
Business Address
CODY M RUSSELL CDCA
700 PARK AVE
IRONTON, OH 45638-1502
Phone number: 740-532-1613
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Mailing Address
CODY M RUSSELL CDCA
PO BOX 108
IRONTON, OH 45638-0108
Phone number: 740-532-1613
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