Individual
MR. RUSSELL JEFFREY BRIDGES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.O
Contact information
Practice address
7002 SHALLOWFORD RD, CHATTANOOGA, TN 37421
(423) 499-0810
Mailing address
155 APACHE TRAIL, RINGGOLD, GA 30736-6826
(706) 937-3915
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
1862
TN
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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