Individual
MR. EDWARD WAYNE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRSS
Contact information
Practice address
5605 CLIFFORD CIR, BIRMINGHAM, AL 35210-4453
(205) 836-3345
Mailing address
5605 CLIFFORD CIR, BIRMINGHAM, AL 35210-4453
(205) 836-3345
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
0373
AL
Other
Enumeration date
01/03/2025
Last updated
01/03/2025
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