Individual
KRISTINE A RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
17088 W BELL RD, SURPRISE, AZ 85374-2433
(623) 826-9093
Mailing address
15284 W ELM ST, GOODYEAR, AZ 85395-7726
(623) 826-9093
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
S016641
AZ
Other
Enumeration date
04/27/2013
Last updated
04/27/2013
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