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Russell Pridgen
NPI 1528424579 · on the registry since 2016 · sole proprietor
Practice
- Address
- 588 Kristin Ln
Winder, GA 30680 - Phone
- (410) 375-1996
- Fax
- (770) 867-1651
Registry record
- Primary taxonomy
- 171W00000X
171W00000X
- Licence states on file
- GA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2016-06-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Georgia