Organization
SUSY RUSSELL PHYSICAL THERAPY LLC
Active
Organization
SUSY RUSSELL PHYSICAL THERAPY LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SUSANNE RUSSELL MSPT (OWNER)
(434) 249-9578
Entity
Organization
Contact information
Practice address
3040 BERKMAR DR STE A1, CHARLOTTESVILLE, VA 22901-1593
(434) 249-9578
Mailing address
3040 BERKMAR DR STE A1, CHARLOTTESVILLE, VA 22901-1593
(434) 249-9578
Taxonomy
Speciality
Code
Description
License number
State
261QP2000X
Physical Therapy Clinic/Center
Primary
2305003603
VA
Other
Enumeration date
07/09/2012
Last updated
10/31/2012
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