Individual
MICHAEL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHARMD
Contact information
Practice address
2821 1ST AVE SE, CEDAR RAPIDS, IA 52402-4806
(319) 365-6306
Mailing address
2821 1ST AVE SE, CEDAR RAPIDS, IA 52402-4806
(319) 365-6306
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
24020
IA
Other
Enumeration date
12/21/2020
Last updated
12/21/2020
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