RUSSELL KACKLEY

UKIAH, CA
NPI1891372553
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date2021-03-26
Last Update Date2021-03-26
Business Address
RUSSELL KACKLEY MD
260 HOSPITAL DR STE 103
UKIAH, CA 95482-4568
Phone number: 707-467-3123
Mailing Address
RUSSELL KACKLEY MD
236 HOSPITAL DR STE B
UKIAH, CA 95482-4561
Phone number: