Individual
NATHAN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
901 W 24TH ST, YUMA, AZ 85364-6384
(814) 599-2849
Mailing address
2651 S 8TH AVE APT 3025, YUMA, AZ 85364-4052
(814) 599-2849
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
LPT-32309
AZ
Other
Enumeration date
06/20/2024
Last updated
06/20/2024
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