Individual
MR. JEFFREY ALAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, MS,
Contact information
Practice address
116 TRESTLE DRIVE, WINTER PARK, CO 80482-8048
(970) 531-1582
Mailing address
PO BOX 743, WINTER PARK, CO 80482-0743
(970) 531-1582
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
7458
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
68606770
—
CO
Enumeration date
10/31/2006
Last updated
07/22/2021
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