Individual
DALE JOSEPH RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MS, ATC, LAT
Contact information
Practice address
2820 COMPTON RD, WICHITA FALLS, TX 76309-4931
(940) 733-5879
Mailing address
2820 COMPTON RD, WICHITA FALLS, TX 76309-4931
(940) 733-5879
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1798
TX
Other
Enumeration date
01/03/2020
Last updated
01/03/2020
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