Bonnie Russell

NPI #1932395688 in Georgetown, Texas

Provider Information

NPI Number: 1932395688
Entity Type: Individual
Name: Bonnie Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dietitian, Registered
Enumeration Date: Sep 17, 2007
Last Updated: Jan 7, 2016

Practice Location

Address: 419 INDIAN MEADOW DRIVE
City: Georgetown
State: Texas
ZIP Code: 78626
Phone: (512) 618-0348

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dietitian, Registered	133V00000X	Primary

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