Individual
MRS. AMANDA E RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PHARMD
Contact information
Practice address
706 CITY AVE N, RIPLEY, MS 38663-1615
(662) 837-3414
Mailing address
227 MAGNOLIA DR, ASHLAND, MS 38603-7897
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
E9597
MS
Other
Enumeration date
09/23/2010
Last updated
09/23/2010
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