Individual
REANNON RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.P.T.
Contact information
Practice address
295 JUMBO RD, MELBOURNE, AR 72556-9175
(870) 373-0532
(870) 895-2626
Mailing address
295 JUMBO RD, MELBOURNE, AR 72556-9175
(870) 373-0532
(870) 895-2626
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3513
AR
Other
Enumeration date
08/28/2012
Last updated
08/28/2012
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