Individual
JOSEPH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
300 EAST MAIN STREET, 1000, VIRGINIA BEACH, VA 23464
(757) 628-4431
(757) 628-4355
Mailing address
300 EAST MAIN STREET, 1000, VIRGINIA BEACH, VA 23464
(757) 628-4431
(757) 628-4355
Taxonomy
Speciality
Code
Description
License number
State
247200000X
Other Technician
Primary
—
—
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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