Healthcare Provider Details

I. General information

NPI: 1902504681
Provider Name (Legal Business Name): RUSSELL L ARMSTRONG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/21/2023
Last Update Date: 08/21/2026
Certification Date: 08/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12572 STATE ROUTE 362
MINSTER OH
45865-9304
US

IV. Provider business mailing address

12572 STATE ROUTE 362
MINSTER OH
45865-9304
US

V. Phone/Fax

Practice location:
  • Phone: 937-214-2251
  • Fax:
Mailing address:
  • Phone: 937-214-2251
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code347C00000X
TaxonomyPrivate Vehicle
License NumberHNH4582
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: