Individual
OLIVIA HICKS RUSSAW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
58 NOMAD CIR, KINSEY, AL 36303-7752
(334) 405-6206
Mailing address
58 NOMAD CIR, KINSEY, AL 36303-7752
(334) 405-6206
Taxonomy
Speciality
Code
Description
License number
State
2278E1000X
Educational Certified Respiratory Therapist
Primary
4858
AL
Other
Enumeration date
12/05/2024
Last updated
12/05/2024
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