Individual
DR. RUSSELL JAMES FANKHOUSER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AU. D. CCCA
Contact information
Practice address
306 SUNSET DRIVE, SUITE 103, JOHNSON CITY, TN 37604
(423) 328-9190
(423) 328-9189
Mailing address
1185 BULLOCK HOLLOW RD, BRISTOL, TN 37620-1113
(423) 878-4171
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
A0000000247
TN
Other
Enumeration date
10/05/2006
Last updated
03/18/2015
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