Individual
SAMANTHA KAE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
106 BRYDON CIR, MADISON, AL 35758-4212
(256) 426-9890
Mailing address
106 BRYDON CIR, MADISON, AL 35758-4212
(256) 426-9890
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
—
—
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
09/03/2025
Last updated
09/03/2025
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