Kelly Russin, PA

NPI #1780745554 in Union City, Georgia

Provider Information

NPI Number: 1780745554
Entity Type: Individual
Name: Kelly Russin, PA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA
Enumeration Date: Dec 13, 2006
Last Updated: Jul 26, 2012

Practice Location

Address: 6325 SHANNON PKWY
Address 2: SUITE D
City: Union City
State: Georgia
ZIP Code: 30291-1538
Phone: (770) 964-1400

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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