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Dana S Russell
Optician in Clovis, California
NPI 1215261425

Dana S Russell is a Optician based in Clovis, CA and is specialized in Optician. Dana S Russell practices in Clovis, CA. The NPI Number for Dana S Russell is 1215261425 and holds a License No. SL6061 (California).

The current practice location address for Dana S Russell is 20 N Dewitt Ave, Clovis, CA and can be reached out via phone at 559-299-2578 and via fax at 559-299-1557.

Location: 20 N Dewitt Ave, Clovis, CA, 93612-0311
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1215261425
Provider Name
Dana S Russell
Credential
Provider Entity Type
Individual
Gender
Male
Address
20 N Dewitt Ave, Clovis, CA, 93612-0311
Phone Number
559-299-2578
Fax Number
559-299-1557
Provider Enumeration Date
09/22/2009
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
20 N Dewitt Ave
City
Clovis
State
California
Zip
93612-0311
Phone Number
559-299-2578
Fax Number
559-299-1557
person
Provider Business Mailing Address Details
Address
20 N Dewitt Ave
City
Clovis
State
California
Zip
93612-0311
Phone Number
559-299-2578
Fax Number
559-299-1557
person
Provider's Taxonomy Details 1
Type
Eye and Vision Services Providers
Classification
Technician/Technologist
Speciality
Optician
Taxonomy
156FX1800X
License No.
SL6061 (California)
Definition
Definition to come...
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