Individual
DR. PAUL RUSSELL HERCULES IV
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT, DPT
Contact information
Practice address
208 OLD MILL RD, MARTINSBURG, WV 25401-9219
(304) 263-5680
Mailing address
208 OLD MILL RD, MARTINSBURG, WV 25401-9219
(304) 263-5680
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT004295
WV
2255A2300X
Athletic Trainer
—
—
Other
Enumeration date
03/30/2017
Last updated
03/11/2022
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