Individual
PATRICIA ELLEN RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
251 LANDIS AVE. SUITE 201, CHULA VISTA, CA 91910
(760) 291-2733
Mailing address
4253 MOUNT HENRY AVE, SAN DIEGO, CA 92117-4702
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
599
CA
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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