Organization
RUSS PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOE RUSS (CEO/OWNER)
(479) 426-6334
Entity
Organization
Contact information
Practice address
2070 MCKENZIE RD, STE A, SPRINGDALE, AR 72762-0747
(479) 250-4014
(479) 250-4015
Mailing address
1002 WESTPARK DR STE 6, BENTONVILLE, AR 72712-4283
(479) 250-4014
(479) 250-4015
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT2874
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
158462721
—
AR
Enumeration date
05/06/2016
Last updated
10/27/2023
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