Individual
MR. CAREY LAVON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
704 MILL ST, LOYALTON, CA 96118-5798
(530) 993-6746
Mailing address
706 MILL ST, LOYALTON, CA 96118-5798
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
—
CA
Other
Enumeration date
09/26/2025
Last updated
10/10/2025
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