Individual
RUSSELL ALLEN DISCH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5504 MENAUL BLVD NE STE F, ALBUQUERQUE, NM 87110-3184
(505) 348-2868
Mailing address
6027 REDONDO SIERRA VIS NE, RIO RANCHO, NM 87144-0607
(505) 228-6289
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
06/03/2021
Last updated
06/13/2021
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