Individual
DR. RUSSELL GLENDON COULTER-KERN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
PH.D.
Contact information
Practice address
1118 N WAYNE ST, NORTH MANCHESTER, IN 46962-1001
(260) 982-5349
Mailing address
1604 W HECKATHORN DR, NORTH MANCHESTER, IN 46962-2217
(260) 982-9383
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
20040896A
IN
Other
Enumeration date
11/08/2005
Last updated
07/08/2007
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