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Individual

FAITH ANASTASIA RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DPT

Contact information

Practice address
16968 W BELL RD STE D-410, SURPRISE, AZ 85374-8943
(632) 299-9190
Mailing address
14287 N 87TH ST STE 220, SCOTTSDALE, AZ 85260-3698
(480) 937-1000

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
12120
SC
225100000X
Physical Therapist
Primary
CP026179T
AZ

Other

Enumeration date
11/21/2023
Last updated
12/31/2024
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