Susan Melissa Russell, LDO

NPI #1568191997 in Hanson, Kentucky

Provider Information

NPI Number
1568191997
Entity Type
Individual
Name
Susan Melissa Russell, LDO
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Technician/Technologist - Optician
Credential
LDO
Enumeration Date
Jun 9, 2022
Last Updated
Jun 9, 2022

Practice Location

Address
420 FACTORY OUTLET DR
City
Hanson
ZIP Code
42413-9513
Phone
(270) 821-7177

Specialties & Taxonomy Codes

Specialty
Technician/Technologist - OpticianOptician

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