Individual
MS. STACY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1941 SAVAGE RD, SUITE 400C, CHARLESTON, SC 29407-4704
(843) 571-2700
Mailing address
1941 SAVAGE RD, SUITE 400C, CHARLESTON, SC 29407-4704
(843) 571-2700
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4020
SC
Other
Enumeration date
09/22/2007
Last updated
08/14/2024
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