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Individual

MR. RUSSELL LEON PALMER JR.

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
RT, BS

Contact information

Practice address
214 WHITE SPAR RD, PRESCOTT, AZ 86303-4236
(928) 777-9064
(928) 777-9183
Mailing address
1045 SCOTT DR, PRESCOTT, AZ 86301-1731
(928) 777-9064
(928) 777-9183

Taxonomy

Speciality
Code
Description
License number
State
247100000X
Radiologic Technologist
Primary
CRT-5873
AZ

Other

Enumeration date
06/17/2008
Last updated
06/18/2008
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