Individual
DR. CONSTANCE RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1572 HIGHWAY 85 N, FAYETTEVILLE, GA 30214-4054
(404) 597-3334
Mailing address
1572 HIGHWAY 85 N, FAYETTEVILLE, GA 30214-4054
(404) 597-3334
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
—
—
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
11/19/2013
Last updated
11/19/2013
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