Individual
JAMIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2215 BREWSTER DR UNIT 438, MYRTLE BEACH, SC 29577-1762
(724) 600-9322
Mailing address
2215 BREWSTER DR UNIT 438, MYRTLE BEACH, SC 29577-1762
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
36916
SC
Other
Enumeration date
11/17/2016
Last updated
11/17/2016
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