Individual
ALLISON MARIE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
500 E BORDER ST STE 250, ARLINGTON, TX 76010-7445
(918) 810-6293
Mailing address
10749 E 29TH PL, TULSA, OK 74129-7805
(918) 810-6293
Taxonomy
Speciality
Code
Description
License number
State
171W00000X
Contractor
0417
OK
2255A2300X
Athletic Trainer
417
OK
2255A2300X
Athletic Trainer
Primary
6596
TX
Other
Enumeration date
09/29/2011
Last updated
05/10/2018
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