Individual
MR. CHERYL ANN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
400 FORT HILL AVE, CANANDAIGUA, NY 14424-1159
(585) 393-7529
Mailing address
7042 W MAIN RD, LOT 6, LIMA, NY 14485-9565
(585) 455-7901
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
66002902
NY
Other
Enumeration date
10/10/2006
Last updated
07/08/2007
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