Individual
MR. JAMES ROBERT RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1915 W PARK DR, STE 102 PHYSICAL THERAPY ASSOCIATES OF WILKES LLC, NORTH WILKESBORO, NC 28659
(336) 903-9293
(336) 903-9295
Mailing address
1915 W PARK DR, STE 102 PHYSICAL THERAPY ASSOCIATES OF WILKES LLC, NORTH WILKESBORO, NC 28659
(336) 903-9293
(336) 903-9295
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2253
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7210769
—
NC
Enumeration date
07/31/2006
Last updated
07/08/2007
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