Individual
DR. AMANDA WILLIAMS RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
1403 RUSSELL AVE, JEFFERSON CITY, TN 37760-2530
(865) 475-3836
Mailing address
3925 SETTLERS TRL, KODAK, TN 37764-1363
(865) 740-4742
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0000026943
TN
Other
Enumeration date
02/28/2007
Last updated
07/08/2007
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