Individual
RUSSELL DAVID DARLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
ATC
Contact information
Practice address
BOX 5102, 1160 N PEACHTREE RM 114, COOKEVILLE, TN 38505-0001
(931) 372-3934
Mailing address
2505 DODSON BRANCH RD, APT D-1, COOKEVILLE, TN 38501-7550
(931) 646-0773
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
474
TN
Other
Enumeration date
08/01/2007
Last updated
08/01/2007
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