Individual
MS. JAN RENEE RUSSELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
419 VILLAGE DR, STE 3, CARLISLE, PA 17013
(717) 240-0330
(717) 240-0233
Mailing address
433 ARCH STREET, CARLISLE, PA 17013
(717) 243-2474
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE000975L
PA
Other
Enumeration date
05/03/2006
Last updated
07/08/2007
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