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1912426123
MICHAEL L RUSSELL
LAS VEGAS, NV
NPI
1912426123
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
171M00000X Case Manager/Care Coordinator
Enumeration Date
2017-09-19
Last Update Date
2017-09-19
Business Address
MICHAEL L RUSSELL
3852 PALOS VERDES ST
LAS VEGAS, NV 89119-6909
Phone number: 702-273-8625
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Mailing Address
MICHAEL L RUSSELL
5138 SILENT VALLEY AVE
LAS VEGAS, NV 89139-7055
Phone number: 702-273-8625
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