Individual
MARLY L RUSSELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PTA
Contact information
Practice address
31 CHOCTAW CENTER, CHEROKEE VILLAGE, AR 72529
(870) 856-4325
(870) 856-4327
Mailing address
31 CHOCTAW CENTER, CHEROKEE VILLAGE, AR 72529
(870) 856-4325
(870) 856-4327
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
PTA4613
AR
Other
Enumeration date
09/07/2021
Last updated
09/07/2021
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