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Individual

VENIUS VERNESTER RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2200 FORT ROOTS DR, NORTH LITTLE ROCK, AR 72114-1709
(501) 257-1000
Mailing address
432 GRACE LOOP, DERMOTT, AR 71638-8763
(870) 538-8284

Taxonomy

Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary

Other

Enumeration date
09/26/2019
Last updated
09/26/2019
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