Individual
MARVIN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
600 KENILWORTH TER NE, WASHINGTON, DC 20019-1924
(202) 280-0489
Mailing address
600 KENILWORTH TER NE, WASHINGTON, DC 20019-1924
(252) 590-6619
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
05/02/2023
Last updated
05/02/2023
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