Individual
BETHANY LABRECQUE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT, DPT
Contact information
Practice address
8191 STAPLES MILL RD, HENRICO, VA 23228-2751
(804) 523-2653
Mailing address
8191 STAPLES MILL RD, HENRICO, VA 23228-2751
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305211198
VA
Other
Enumeration date
07/11/2019
Last updated
11/15/2021
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