Individual
KAREN LYNN RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
2700 CLEARLAKE RD, COCOA, FL 32922-5716
(321) 631-0373
Mailing address
2700 CLEARLAKE RD, COCOA, FL 32922-5716
(321) 631-0373
Taxonomy
Speciality
Code
Description
License number
State
156FX1800X
Optician
Primary
—
—
Other
Enumeration date
03/26/2024
Last updated
03/26/2024
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