Individual
MRS. JESSICA DAIR RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1351 S COUNTY TRL, SUITE 301, EAST GREENWICH, RI 02818-5105
(401) 398-0860
Mailing address
1351 S COUNTY TRL, SUITE 301, EAST GREENWICH, RI 02818-5105
(401) 398-0860
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
10/01/2012
Last updated
09/03/2013
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