Individual
LACI RUSS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN, IBCLC
Contact information
Practice address
21675 SILVER OAKS CIR, ATHENS, AL 35613-5234
(256) 874-1020
Mailing address
21675 SILVER OAKS CIR, ATHENS, AL 35613-5234
(256) 874-1020
Taxonomy
Speciality
Code
Description
License number
State
163WL0100X
Lactation Consultant (Registered Nurse)
Primary
1-140592
AL
Other
Enumeration date
06/12/2024
Last updated
06/12/2024
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