Individual
DIANE MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CMF
Contact information
Practice address
2344 LOCKPORT OLCOTT RD, NEWFANE, NY 14108-9510
(716) 471-3080
Mailing address
2344 LOCKPORT OLCOTT RD, NEWFANE, NY 14108-9510
(716) 471-3080
Taxonomy
Speciality
Code
Description
License number
State
332B00000X
Durable Medical Equipment & Medical Supplies
Primary
C49780
NY
Other
Enumeration date
07/03/2013
Last updated
07/03/2013
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