Individual
MR. JAY C RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
175 GREAT OAKS TRL, WADSWORTH, OH 44281-8712
(330) 336-3588
(330) 336-5479
Mailing address
3747 POE RD, MEDINA, OH 44256-9791
(330) 722-3713
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
03-3-09809
OH
Other
Enumeration date
10/19/2005
Last updated
07/08/2007
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