Individual
CYNTHIA LEE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
156 ROUTE 302, PINE BUSH, NY 12566-7130
(845) 744-2031
Mailing address
PO BOX 175, BULLVILLE, NY 10915-0175
(845) 361-1874
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
—
—
Other
Enumeration date
01/24/2011
Last updated
01/24/2011
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