Individual
HOWARD RUSSELL III
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
400 FORT HILL AVE, CANANDAIGUA, NY 14424-1159
(585) 393-7561
Mailing address
PO BOX 824, ROCKWELL, NC 28138-0824
(585) 356-6668
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
343533500314R
NY
Other
Enumeration date
09/21/2015
Last updated
09/21/2015
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