Individual
RUSSELL WORTHY CAMERON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
1600 SUTTER PL, CLOVIS, NM 88101-4611
(505) 769-4490
(505) 935-0011
Mailing address
432 MONTICELLO PARKWAY DR, PORTALES, NM 88130-9273
(505) 226-3030
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
3292
NM
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00637734
—
NM
Enumeration date
11/21/2006
Last updated
07/08/2007
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