Individual
DANIEL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
7233 WHIPPLE AVE NW, NORTH CANTON, OH 44720-7137
(330) 498-8200
Mailing address
1619 SPERRY LN SE, CANTON, OH 44709-4852
(330) 704-0835
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PT 007055
OH
Other
Enumeration date
10/18/2007
Last updated
10/18/2007
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