NPI 1013602788

Ryan Russell

Practitioner Student in an Organized Health Care Education/Training Program Fayetteville, AR

Practice location

Address: 1125 N College Ave, Fayetteville, AR 72703-1908
Phone: (479) 521-8260
Fax: (479) 444-7820

Registered specialties

Student in an Organized Health Care Education/Training Program Primary

Student, Health Care Taxonomy 390200000X

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Registry record

NPI: 1013602788
Entity type: Individual
Sex (as registered): Male
NPI issued: 10 Apr 2023
Record last updated: 10 Apr 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.