Individual
DR. TREY RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.C.
Contact information
Practice address
405 PHARR RD NE, ATLANTA, GA 30305-3200
(404) 231-1872
Mailing address
6093 SIMONE ST, ACWORTH, GA 30101-0049
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
CHIR010597
GA
Other
Enumeration date
06/25/2024
Last updated
06/25/2024
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