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Individual

MR. RUBEN REGINALD RUSSELL III

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
STNA

Contact information

Practice address
22091 LIBBY RD APT 101 AA, BEDFORD HTS., OH 44146
(216) 392-3108
Mailing address
22091 LIBBY RD APT 101 AA, BEDFORD HTS., OH 44146
(216) 392-3108

Taxonomy

Speciality
Code
Description
License number
State
246RP1900X
Phlebotomy Technician
Primary
OH23128M211
OH

Other

Enumeration date
12/03/2012
Last updated
12/03/2012
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