Individual
RUSSELL CHRISTIAN BETZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RN
Contact information
Practice address
1302 NORTHGLEN LN, LAKELAND, FL 33813-1823
(863) 646-4908
Mailing address
4798 S FLORIDA AVE, LAKELAND, FL 33813-2181
(863) 646-4908
Taxonomy
Speciality
Code
Description
License number
State
251J00000X
Nursing Care Agency
Primary
RN3164722
FL
Other
Enumeration date
10/17/2017
Last updated
10/17/2017
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