Individual
DR. HUBERT WILLIAM RUSSELL JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
15195 ALLEN RD, SOUTHGATE, MI 48195-2921
(734) 284-9800
(734) 284-9088
Mailing address
15195 ALLEN RD, SOUTHGATE, MI 48195-2921
(734) 284-9800
(734) 284-9088
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
HR004208
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2906559
—
MI
01
—
95OH227870
NEW GRP # AS OF 7-18-06
MI
01
—
95OH227880
DR RUSSELL'S INDIVDUAL #
MI
01
—
OQ25014
OLD BCBS #
MI
Enumeration date
06/13/2006
Last updated
04/22/2008
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