Individual
MR. RUSSELL GENE SMITH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
100 HEALTHY WAY # 1110, ANDERSON, SC 29621-2067
(864) 261-3099
(864) 261-6617
Mailing address
322 SMITHFIELD DR, ANDERSON, SC 29621-3645
(864) 617-7538
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
925
SC
Other
Enumeration date
11/01/2006
Last updated
07/08/2007
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