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1770819096
RUSSELL JOHN ENEDY
JOHNSTOWN, PA
NPI
1770819096
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
363A00000X Physician Assistant
(Licence: PA MA053940)
Enumeration Date
2009-10-21
Last Update Date
2014-10-17
Business Address
RUSSELL JOHN ENEDY PA-C
1111 FRANKLIN ST SUITE 410
JOHNSTOWN, PA 15905-4330
Phone number: 814-536-7851
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Mailing Address
RUSSELL JOHN ENEDY PA-C
1086 FRANKLIN ST
JOHNSTOWN, PA 15905-4305
Phone number: 814-410-8300
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