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1861423790
RUSSELL TALMAGE JOHNSON
OXFORD, MS
NPI
1861423790
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
2255A2300X Specialist/Technologist, Athletic Trainer
(Licence: MS AT0217)
Enumeration Date
2006-07-06
Last Update Date
2007-07-08
Business Address
-- RUSSELL TALMAGE JOHNSON ATC
1190 S 18TH STREET EXT
OXFORD, MS 38655-5378
Phone number: 662-234-0424
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Mailing Address
-- RUSSELL TALMAGE JOHNSON ATC
1207 OLD LAKE CV
OXFORD, MS 38655-8152
Phone number: 662-236-2368
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