Individual
MR. DENNIS MICHEAL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
ATC, NRP
Contact information
Practice address
192 RUSSELL ST, LEWISTON, ME 04240-5435
(207) 777-6006
Mailing address
192 RUSSELL ST, LEWISTON, ME 04240-5435
(207) 777-6006
Taxonomy
Speciality
Code
Description
License number
State
146L00000X
Paramedic
20114
ME
2255A2300X
Athletic Trainer
Primary
AT139
ME
Other
Enumeration date
12/18/2006
Last updated
06/15/2014
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