Individual
MCKEEG RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CNA
Contact information
Practice address
26045 WOODARD AVE, MOFFAT, CO 81143-9782
(719) 221-6224
Mailing address
26045 WOODARD AVE, MOFFAT, CO 81143-9782
(719) 221-6224
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
TNA00003041
CO
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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