Individual
MR. RUSSELL S MEDBERY JR.
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Contact information
Practice address
360 TOLLAND TPKE, SUITE 3B, MANCHESTER, CT 06042-1771
(860) 646-1157
(860) 646-9877
Mailing address
360 TOLLAND TPKE, SUITE 3B, MANCHESTER, CT 06042-1771
(860) 646-1157
(860) 646-9877
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
000040
CT
Other
Enumeration date
06/15/2006
Last updated
07/08/2007
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