Organization
DR LARRY J RUSSELL INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LARRY J RUSSELL DC (PRESIDENT)
(765) 362-1111
Entity
Organization
Contact information
Practice address
406 E SOUTH BLVD, CRAWFORDSVILLE, IN 47933-3762
(765) 362-1111
(765) 362-2609
Mailing address
406 E SOUTH BLVD, CRAWFORDSVILLE, IN 47933-3762
(765) 362-1111
(765) 362-2609
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
08000620A
IN
Other
Enumeration date
09/19/2012
Last updated
09/19/2012
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