Individual
JEFF RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1300 ALBANY ST, BEECH GROVE, IN 46107-1536
(317) 782-7200
Mailing address
3200 COLD SPRING RD APT 220, INDIANAPOLIS, IN 46222-1960
(317) 361-5293
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05009096A
IN
Other
Enumeration date
07/24/2020
Last updated
07/24/2020
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