GORDON KENNETH RUSSELL

GROVEPORT, OH
NPI1740069673
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OH  185707)
Enumeration Date2023-09-28
Last Update Date2023-09-28
Business Address
GORDON KENNETH RUSSELL
6020 GROVEPORT RD
GROVEPORT, OH 43125-1005
Phone number: 614-567-6274
Mailing Address
GORDON KENNETH RUSSELL
6020 GROVEPORT RD
GROVEPORT, OH 43125-1005
Phone number:
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