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Jeff Russell

Student in an Organized Health Care Education/Training Program in Toledo, OH. Individual provider (NPI-1).

NPI number1336765643
StatusActive
Last updated in NPPESJun 23, 2020

Details

NPI
1336765643
Entity type
Individual (NPI-1)
Name
Jeff Russell
Sex
Male
Sole proprietor
No
Enumeration date
Jun 23, 2020
Certification date
Jun 23, 2020
Last updated
Jun 23, 2020

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
390200000X Student in an Organized Health Care Education/Training Program––Yes

Practice location

3000 Arlington Ave
Toledo, OH 43614-2595

Phone 419-383-4000

Mailing address

3000 Arlington Ave
Toledo, OH 43614-2598

Phone 419-383-4000

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