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DR. JEFFERY A. RUSSELL DC
>> Chiropractor >> Chiropractic ProvidersRegistrant NPI Number: 1427122951
Individual Registrant:DR. JEFFERY A. RUSSELL DC
Gender: M
Sole Proprietor
Gender: M
Sole Proprietor
Location and contact information for practice:
624 N MAIN AVE PINE MOUNTAIN, GA 31822-2403 US
Tel: 706-663-8801 Fax: --
Tel: 706-663-8801 Fax: --
Contact information for business:
624 N MAIN AVE P.O. BOX 1690 PINE MOUNTAIN, GA 31822-2403 US
Tel: 706-663-8801 Fax: --
Tel: 706-663-8801 Fax: --
Registration Information:
NPI: 1427122951
Entity Type: Individual
Entity Type: Individual
Specialty information:
| Primary | Code | Category/Description | State | License Number |
|---|---|---|---|---|
| Y | 111N00000X | Chiropractic Providers Chiropractor | GA | CHIR007961 |
Legacy codes, insurance codes and state license numbers:
| Issuer | Number | State | Type |
|---|---|---|---|
