Individual
RUSSELL WAYNE HARRELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
6007 ROGERS CAMPGROUND RD SE, ELIZABETH, IN 47117-9342
(812) 737-1868
Mailing address
6007 ROGERS CAMPGROUND RD SE, ELIZABETH, IN 47117-9342
(812) 737-1868
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
A02178
KY
Other
Enumeration date
10/21/2008
Last updated
10/21/2008
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