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1760092050
RUSSELL IRBY
SHREVEPORT, LA
NPI
1760092050
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2020-08-03
Last Update Date
2022-06-09
Business Address
RUSSELL IRBY
458 HERNDON ST
SHREVEPORT, LA 71101-4859
Phone number: 318-429-6938
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Mailing Address
RUSSELL IRBY
458 HERNDON ST
SHREVEPORT, LA 71101-4859
Phone number: 318-429-6938
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