MR. John Grover Russell, NCSP
NPI #1619066156 in Casa Grande, Arizona
Provider Information
- NPI Number
- 1619066156
- Entity Type
- Individual
- Name
- MR. John Grover Russell, NCSP
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Specialist
- Credential
- NCSP
- Enumeration Date
- Oct 12, 2006
- Last Updated
- Jul 26, 2007
Practice Location
- Address
- 8188 W BARTLETT RD
- City
- Casa Grande
- State
- Arizona
- ZIP Code
- 85222-7336
- Phone
- (520) 431-4314
Specialties & Taxonomy Codes
| Specialty |
|---|
| Specialist |
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