MEDICARE: MR. RUSSELL WILLIAM TURNER M.A., TSHH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2355S0801X	Speech-Language Assistant

General Provider Information

NPI Number	:	1740425586
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. RUSSELL WILLIAM TURNER M.A., TSHH

Provider Business Mailing Address
First Line	:	941 SOUTH AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2746
Country	:	US
Telephone Number	:	585-278-1895
Fax Number	:	585-278-1995

Provider Business Practice Location Address
First Line	:	941 SOUTH AVE
Second Line	:
City	:	ROCHESTER
State	:	NY
Zip	:	14620-2746
Country	:	US
Telephone Number	:	585-278-1895
Fax Number	:	585-278-1995

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/09/2008
Last Update Date	:	12/09/2008

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