Individual
MR. RICHARD A. RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LD
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-7664
Mailing address
243 W 12TH ST, SALEM, OH 44460-1523
(330) 337-9794
Taxonomy
Speciality
Code
Description
License number
State
133V00000X
Registered Dietitian
Primary
LD4685
OH
Other
Enumeration date
04/25/2007
Last updated
07/08/2007
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