Individual
MRS. JODI LYNN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MS, ATC
Contact information
Practice address
1350 BROADCASTING RD, SUITE 201, WYOMISSING, PA 19610-3229
(610) 685-9600
(610) 685-6700
Mailing address
1350 BROADCASTING RD, SUITE 201, WYOMISSING, PA 19610-3229
(610) 685-9600
(610) 685-6700
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
RT004416
PA
Other
Enumeration date
09/22/2011
Last updated
09/22/2011
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