Individual
MITCHELL RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5339 WOODSON RD, MISSION, KS 66202-1928
(913) 909-7115
Mailing address
5339 WOODSON RD, MISSION, KS 66202-1928
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
14-02254
KS
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
05/12/2011
Last updated
12/12/2020
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