Individual
MR. GARY LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PD
Contact information
Practice address
305 W MAIN ST, TRUMANN, AR 72472-3114
(870) 483-6325
(870) 483-6483
Mailing address
305 W MAIN ST, TRUMANN, AR 72472-3114
(870) 483-6325
(870) 483-6483
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
5401
AR
Other
Enumeration date
11/14/2006
Last updated
07/08/2007
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