Individual
ALEXANDRA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
400 N PEPPER AVE, SUITE 107, COLTON, CA 92324-1801
(207) 431-1016
Mailing address
PO BOX 266, WISCASSET, ME 04578-0266
(207) 431-1016
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
02/22/2016
Last updated
02/22/2016
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