Individual
MR. RUSSELL D GANNON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MSPT
Contact information
Practice address
616 GADSDEN HWY, SUITE A, BIRMINGHAM, AL 35235-2501
(205) 833-0881
(205) 833-1190
Mailing address
548 TWIN BRANCH DR, BIRMINGHAM, AL 35226-2342
(205) 823-4236
Taxonomy
Speciality
Code
Description
License number
State
2251X0800X
Orthopedic Physical Therapist
Primary
PTH3502
AL
Other
Enumeration date
09/24/2006
Last updated
07/08/2007
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