Individual
DEANA RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
900 N MADISON BLVD, ROXBORO, NC 27573-4545
(336) 599-8396
Mailing address
900 N MADISON BLVD, ROXBORO, NC 27573-4545
(336) 599-8396
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
13131
NC
Other
Enumeration date
01/21/2011
Last updated
01/21/2011
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