Individual
AMANDA DIDAWICK RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
103 SLEEPY DR STE G, SPRING LAKE, NC 28390-3319
(910) 423-5622
(910) 378-1755
Mailing address
4602 CUMBERLAND RD, FAYETTEVILLE, NC 28306-2412
(910) 423-5622
(910) 378-1755
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
P20626
NC
Other
Enumeration date
08/30/2021
Last updated
02/01/2023
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