Individual
MS. KAREN MARIE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DTR, CHC
Contact information
Practice address
2203 DESSECKER DR NE, DOVER, OH 44622
(330) 340-8314
Mailing address
2203 DESSECKER DR NE, DOVER, OH 44622-6988
(330) 340-8314
Taxonomy
Speciality
Code
Description
License number
State
136A00000X
Registered Dietetic Technician
Primary
717561
OH
Other
Enumeration date
03/08/2011
Last updated
03/08/2011
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