Individual
RUSSELL PEARSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
1000 STACIE DR, HAZLETON, PA 18201-5690
(570) 453-5110
Mailing address
70 DEAD END LN, LEHIGHTON, PA 18235-9564
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
TE1000300
PA
Other
Enumeration date
01/31/2013
Last updated
01/31/2013
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