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Individual

JENNIFER RENEE RUSSELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CO7A/L

Contact information

Practice address
1 VETERAN'S WAY, KNOXVILLE, TN 37931
(865) 862-8100
Mailing address
132 DEWEY DAVIS RD, WALLAND, TN 37886
(865) 221-2125

Taxonomy

Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
3201
TN

Other

Enumeration date
08/11/2021
Last updated
08/13/2021
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