Individual
HOWARD MICHAEL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LPT
Contact information
Practice address
3325 POCAHONTAS ROAD, ST ELIZABETH HEALTH SERVICES, BAKER CITY, ID 97814-1464
(541) 523-8130
(541) 523-1793
Mailing address
PO BOX 198, HARRISON, ID 83833-0198
(208) 755-5704
(208) 689-3183
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
0287
OR
225100000X
Physical Therapist
Primary
PT1338
ID
Other
Enumeration date
11/15/2006
Last updated
07/08/2007
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