EDWARD JOHN RUSSELL

MESA, AZ
NPI1730599226
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy224Z00000X Occupational Therapy Assistant
(Licence: AZ  5776)
Enumeration Date2014-05-06
Last Update Date2014-05-06
Business Address
Mr. EDWARD JOHN RUSSELL COTAL
5358 E BASELINE RD
MESA, AZ 85206-4716
Phone number: 480-630-3005
Mailing Address
Mr. EDWARD JOHN RUSSELL COTAL
25117 SW PARKWAY AVE STE D
WILSONVILLE, OR 97070-9697
Phone number:
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