Ivory Russ
NPI #1255042826 in St Augustine, Florida
Provider Information
- NPI Number
- 1255042826
- Entity Type
- Individual
- Name
- Ivory Russ
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Home Health
- Enumeration Date
- Dec 5, 2022
- Last Updated
- Jan 30, 2023
Practice Location
- Address
- 300 SUMMER BREEZE WAY APT 1106
- City
- St Augustine
- State
- Florida
- ZIP Code
- 32086-1804
- Phone
- (912) 342-9829
Specialties & Taxonomy Codes
| Specialty |
|---|
| Home Health |
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Organizations
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|---|---|
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