Individual
RUSSELL L. BRANCH JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
531 ROSELANE ST NW, SUITE 830, MARIETTA, GA 30060
(770) 794-0477
(770) 794-3108
Mailing address
531 ROSELANE ST NW, SUITE 830, MARIETTA, GA 30060-6913
(770) 794-0477
(770) 794-3108
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
RN174552
GA
Other
Enumeration date
03/09/2006
Last updated
08/15/2018
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