Individual
GLENN RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4611 N 126TH AVE, OMAHA, NE 68164-6900
(402) 651-2649
Mailing address
4611 N 126TH AVE, OMAHA, NE 68164-6900
Taxonomy
Speciality
Code
Description
License number
State
3747P1801X
Personal Care Attendant
Primary
—
—
Other
Enumeration date
02/04/2025
Last updated
02/04/2025
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