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Individual
RUSSELL GARRISON
Active
Individual
RUSSELL GARRISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
17474
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000035264
BMC
MA
01
—
043527
CONNECTICARE
MA
01
—
043527497
PIONEER
MA
01
—
103355100
DEPT OF LABOR
—
01
—
28117
HEALTH NEW ENGLAND
MA
01
—
690675
TUFTS
MA
05
—
9715568
—
MA
01
—
972730
NETWOTK HEALTH
MA
Enumeration date
11/10/2008
Last updated
11/10/2008
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