Individual
HOLLY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
961 THREEWOOD CIR, BOWLING GREEN, KY 42103-2480
(270) 991-9904
Mailing address
961 THREEWOOD CIR, BOWLING GREEN, KY 42103-2480
(270) 991-9904
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
010316
KY
Other
Enumeration date
02/19/2015
Last updated
02/19/2015
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