Individual
MS. JODI RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RPH
Contact information
Practice address
2 S BROADWAY, PERU, IN 46970-2232
(765) 472-4367
Mailing address
429 AVALON DR, GREENTOWN, IN 46936-1608
(176) 543-4802
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
26016939A
IN
Other
Enumeration date
11/19/2020
Last updated
11/19/2020
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