Individual
ALAN S RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
8111 E HARRY, WICHITA, KS 67207
(316) 685-7661
(316) 685-0227
Mailing address
1851 N WEBB RD, ATTN FLR2, WICHITA, KS 67206-3413
(316) 636-2010
(613) 858-3830
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1040-2
KS
Other
Enumeration date
02/28/2006
Last updated
02/26/2008
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