Individual
AGNES MACFIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1136 KINCAID BRIDGE RD, WINNSBORO, SC 29180-7116
(803) 635-6481
Mailing address
211 W LIBERTY ST, WINNSBORO, SC 29180-1421
(803) 635-6481
Taxonomy
Speciality
Code
Description
License number
State
133VN1006X
Metabolic Nutrition Registered Dietitian
Primary
272
SC
Other
Enumeration date
07/24/2014
Last updated
07/24/2014
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