Individual
KELLY KRISTINA RUSS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
3915 GOLDEN VALLEY RD, GOLDEN VALLEY, MN 55422-4249
(612) 868-4885
Mailing address
5450 VAGABOND LN N, PLYMOUTH, MN 55446-1309
(763) 478-6893
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
10160
MN
Other
Enumeration date
01/04/2016
Last updated
01/05/2016
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