Individual
EVELYN RUTH RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
701 25TH AVE S, #500, MINNEAPOLIS, MN 55454-1513
(612) 672-6697
Mailing address
1960 E RIVER TER, MINNEAPOLIS, MN 55414-3672
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
4575
MN
Other
Enumeration date
09/02/2006
Last updated
07/08/2007
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