Individual
THOMAS RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
380 STEVENS AVE, SUITE 314, SOLANA BEACH, CA 92075-2063
(858) 755-5200
(858) 755-5201
Mailing address
380 STEVENS AVE, SUITE 314, SOLANA BEACH, CA 92075-2063
(858) 755-5200
Taxonomy
Speciality
Code
Description
License number
State
225XP0019X
Physical Rehabilitation Occupational Therapist
Primary
292213
CA
Other
Enumeration date
07/27/2016
Last updated
11/07/2016
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