Individual
MRS. KIM KOEHLER RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3666 KEARNY VILLA RD, SUITE 308, SAN DIEGO, CA 92123-1951
(858) 505-5460
Mailing address
715 COLIMA STREET, LA JOLLA, CA 92037
(619) 894-9398
Taxonomy
Speciality
Code
Description
License number
State
225XH1200X
Hand Occupational Therapist
Primary
9543
CA
Other
Enumeration date
03/26/2009
Last updated
03/26/2009
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