Individual
ERICA RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
A.T.
Contact information
Practice address
284 EAST AVE APT C, NORWALK, CT 06855-1920
(845) 531-8229
Mailing address
284 EAST AVE APT C, NORWALK, CT 06855-1920
(845) 531-8229
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
002246-1
NY
Other
Enumeration date
02/27/2014
Last updated
02/27/2014
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