Timothy Glen Russell
NPI #1144993924 in Bowling Green, Kentucky
Provider Information
- NPI Number
- 1144993924
- Entity Type
- Individual
- Name
- Timothy Glen Russell
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Peer Specialist
- Enumeration Date
- Jul 28, 2021
- Last Updated
- Jul 28, 2021
Practice Location
- Address
- 380 SUWANNEE TRAIL ST
- City
- Bowling Green
- State
- Kentucky
- ZIP Code
- 42103-7956
- Phone
- (270) 901-5000
Specialties & Taxonomy Codes
| Specialty |
|---|
| Peer Specialist |
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