Russel Main
NPI #1104410711 in Morgantown, West Virginia
Provider Information
- NPI Number
- 1104410711
- Entity Type
- Individual
- Name
- Russel Main
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Community Health Worker
- Enumeration Date
- Feb 24, 2021
- Last Updated
- Feb 24, 2021
Practice Location
- Address
- 780 ALPINE ST
- City
- Morgantown
- State
- West Virginia
- ZIP Code
- 26505-2532
- Phone
- (304) 692-6798
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Health Worker |
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