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Individual

DAVID S RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
RPA-C

Contact information

Practice address
438 HIGH ST, LOCKPORT, NY 14094-4742
(716) 439-0193
(716) 438-3543
Mailing address
438 HIGH ST, LOCKPORT, NY 14094-4742
(716) 439-0193
(716) 438-3543

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
005332-1
NY

Other

Enumeration date
07/07/2005
Last updated
09/24/2010
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