JUSTIN LEE RUSSELL

BRADENTON, FL
NPI1710539416
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy363AS0400X Physician Assistant, Surgical
Enumeration Date2019-07-12
Last Update Date2020-05-07
Business Address
JUSTIN LEE RUSSELL PA
11505 RANGELAND PKWY
BRADENTON, FL 34211-4041
Phone number: 941-362-8662
Mailing Address
JUSTIN LEE RUSSELL PA
11505 RANGELAND PKWY
BRADENTON, FL 34211-4041
Phone number: 941-362-8662
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