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1710254388
AMANDA RUSSELL
LA VISTA, NE
NPI
1710254388
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: NE 12408)
Enumeration Date
2011-11-25
Last Update Date
2011-11-25
Business Address
AMANDA RUSSELL
8380 HARRISON ST
LA VISTA, NE 68128-2918
Phone number: 402-592-7990
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Mailing Address
AMANDA RUSSELL
8380 HARRISON ST
LA VISTA, NE 68128-2918
Phone number:
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