MARY ELIZABETH RUSSOM

LOGAN, WV
NPI1902630510
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy3747P1801X Technician Personal Care Attendant
Enumeration Date2024-08-27
Last Update Date2024-08-27
Business Address
MARY ELIZABETH RUSSOM
164 SUNBEAM RD
LOGAN, WV 25601-1310
Phone number: 304-733-1094
Mailing Address
MARY ELIZABETH RUSSOM
164 SUNBEAM RD
LOGAN, WV 25601-1310
Phone number:
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