Most Relevant Information
Provider Data
| NPI Number: | 1003241563 |
| Provider Name: | RUSSELL MILLER CP |
| Entity Type: | Individual |
| Taxonomy Code: | 224P00000X |
| Specialty: | Prosthetist |
| License Number: | PS 60371032 |
Most Important Dates
| Enumeration Date: | 09/03/2013 |
| Last Updated: | 09/03/2013 |
Provider Practice Location
3508 12TH AVE NE
OLYMPIA
WA
985065218
Practice Location Phone/Fax
| Phone: | 3604591099 |
| Fax: | 3604591794 |
Provider Mailing Location
3508 12TH AVE NE
OLYMPIA
WA
985065218
Provider Mailing Phone/Fax
| Phone: | 3604591099 |
| Fax: | 3604591794 |