Dr. Chris Russell, PA

NPI #1073816906 in Valrico, Florida

Provider Information

NPI Number: 1073816906
Entity Type: Organization
Organization Name: Dr. Chris Russell, PA
Primary Specialty: Optometrist
Enumeration Date: Dec 15, 2010
Last Updated: Dec 15, 2010

Practice Location

Address: 3466 LITHIA PINECREST RD
City: Valrico
State: Florida
ZIP Code: 33596-6301
Phone: (813) 657-3937

Authorized Official

Name: DR. CLARENCE HENRY RUSSELL III, O.D.
Title: PRESIDENT
Phone: (813) 657-3937

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Optometrist	152W00000X	Primary

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