Individual
CHRISTOPHER M. RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
EMT-PARAMEDIC
Contact information
Practice address
20281 XITA AVE, PORT CHARLOTTE, FL 33952-1234
(941) 979-9930
Mailing address
20281 XITA AVE, PORT CHARLOTTE, FL 33952-1234
(941) 979-9930
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
095714
PA
Other
Enumeration date
12/07/2015
Last updated
12/07/2015
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