Individual
MS. TAMARA RACHELLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR
Contact information
Practice address
4500 S LANCASTER RD, DALLAS, TX 75216-7167
(800) 849-3597
Mailing address
4458 SEVEN PINES DR, GRAND PRAIRIE, TX 75052-1676
(972) 641-4429
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
110286
TX
Other
Enumeration date
06/25/2010
Last updated
06/25/2010
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