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1891372553
RUSSELL KACKLEY
UKIAH, CA
NPI
1891372553
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2021-03-26
Last Update Date
2021-03-26
Business Address
RUSSELL KACKLEY MD
260 HOSPITAL DR STE 103
UKIAH, CA 95482-4568
Phone number: 707-467-3123
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Mailing Address
RUSSELL KACKLEY MD
236 HOSPITAL DR STE B
UKIAH, CA 95482-4561
Phone number:
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