Individual
ROBERT J RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
S.T.S.A.
Contact information
Practice address
420 W BILLY CREEK DR, LAKESIDE, AZ 85929-6830
(928) 369-8117
Mailing address
420 W BILLY CREEK DR, LAKESIDE, AZ 85929-6830
(928) 369-8117
Taxonomy
Speciality
Code
Description
License number
State
246ZS0410X
Surgical Technologist
Primary
—
—
Other
Enumeration date
05/20/2010
Last updated
05/20/2010
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