Individual
JOSHUA ALLAN RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
2301 10TH AVE, LEAVENWORTH, KS 66048-4214
(913) 682-2929
Mailing address
2301 10TH AVE, LEAVENWORTH, KS 66048-4214
(913) 682-2929
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
2025000170
MO
152W00000X
Optometrist
Primary
2254
KS
152W00000X
Optometrist
3277
OK
Other
Enumeration date
05/31/2024
Last updated
07/28/2025
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