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1821691361
GARY STEPHEN RUSSELL
MADISONVILLE, KY
NPI
1821691361
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
183500000X Pharmacist
(Licence: KY 008301)
Enumeration Date
2020-11-18
Last Update Date
2020-11-18
Business Address
GARY STEPHEN RUSSELL R.Ph.
1128 N MAIN ST STE 1
MADISONVILLE, KY 42431-1265
Phone number: 270-825-2775
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Mailing Address
GARY STEPHEN RUSSELL R.Ph.
1128 N MAIN ST STE 1
MADISONVILLE, KY 42431-1265
Phone number: 270-825-2775
Copy
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