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Individual

DR. ANTHONY C RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
1852 W GRAND BLVD, 1852 W. GRAND BLVD, DETROIT, MI 48208-1006
(313) 894-4444
(313) 894-1291
Mailing address
1852 W GRAND BLVD, 1852 W. GRAND BLVD, DETROIT, MI 48208-1006
(313) 894-4444
(313) 894-1291

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary

Other

Enumeration date
05/21/2007
Last updated
07/08/2007
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