Individual
MRS. BRITTANY RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MAT, ATC, LAT
Contact information
Practice address
703 E MAIN ST, LEBANON, KY 40033-8695
(270) 699-9503
Mailing address
214 AHLENA WAY, SPRINGFIELD, KY 40069-9568
(502) 649-3200
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
AT1074
KY
Other
Enumeration date
01/24/2017
Last updated
01/24/2017
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