Individual
BRYAN M RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
105 COLLIER RD NW, SUITE 2000, ATLANTA, GA 30309-1710
(404) 352-1053
(404) 350-0840
Mailing address
100 GALLERIA PKWY SE, SUITE 410, ATLANTA, GA 30339-3179
(770) 953-6929
(770) 953-6972
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
008561
GA
Other
Enumeration date
10/04/2006
Last updated
01/14/2013
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