Organization
RUSSELL PET M.D. INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. L RUSSELL PET MD (PRESIDENT)
(508) 675-0089
Entity
Organization
Contact information
Practice address
4 HARTWELL ST, FALL RIVER, MA 02721-3019
(508) 675-0089
(508) 675-2233
Mailing address
4 HARTWELL ST, FALL RIVER, MA 02721-3019
(508) 675-0089
(508) 675-2233
Taxonomy
Speciality
Code
Description
License number
State
2084P0804X
Child & Adolescent Psychiatry Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3154564
—
MA
Enumeration date
04/22/2010
Last updated
04/22/2010
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