Individual
DR. BRENT DA SILVA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
4082 NANCY CREEK WAY NE, ATLANTA, GA 30319-1738
(404) 317-2842
Mailing address
4082 NANCY CREEK WAY NE, ATLANTA, GA 30319-1738
(404) 317-2842
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
2062
GA
Other
Enumeration date
05/07/2014
Last updated
05/07/2014
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