Individual
VIRGIE RUSSELL-ANGLE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
120 VETERANS DR, OXFORD, MS 38655-3578
(662) 236-1218
Mailing address
PO BOX 579, SUMMIT, MS 39666-0579
(601) 276-3900
(601) 276-3939
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
2958
MS
Other
Enumeration date
10/19/2015
Last updated
10/19/2015
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