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1811525595
TIFFANY LEE RUSSELL
DYESS AFB, TX
NPI
1811525595
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Former Name
TIFFANY LEE REID
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
171000000X Military Health Care Provider
(Licence: TX T2968)
Enumeration Date
2020-03-30
Last Update Date
2021-09-14
Business Address
TIFFANY LEE RUSSELL DO
697 LOUISIANA RD
DYESS AFB, TX 79607-1141
Phone number: 325-696-6600
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Mailing Address
TIFFANY LEE RUSSELL DO
697 LOUISIANA RD
DYESS AFB, TX 79607-1141
Phone number: 325-696-6600
Copy
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