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Individual

RUSSELL WAYNE CARR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT, DPT

Contact information

Practice address
1704 E STONE DR STE 120, KINGSPORT, TN 37660-4679
(423) 765-0985
Mailing address
6397 LEE HWY STE 300, CHATTANOOGA, TN 37421-4915
(423) 238-8930
(423) 254-5217

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
12261
TN
225100000X
Physical Therapist
PT013054
GA

Other

Enumeration date
08/13/2017
Last updated
03/09/2020
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