Individual
CAROLINE F RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1001 COLLEGE AVE, JACKSON, AL 36545-2402
(251) 744-5124
Mailing address
7291 HIGHWAY 41, PONTOTOC, MS 38863-6705
(662) 509-2398
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
6596
AL
Other
Enumeration date
01/24/2025
Last updated
01/24/2025
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