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Individual

MR. RUSSELL JAMES ANNIS JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
P.T.

Contact information

Practice address
1639 N NATIONAL RD, COLUMBUS, IN 47201
(812) 669-1687
(812) 775-1035
Mailing address
600 OAKMONT LN STE 600C, WESTMONT, IL 60559-5548
(630) 575-6250

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
05003020A
IN
225100000X
Physical Therapist
2305207421
VA
225100000X
Physical Therapist
PT-04982
OH

Other

Enumeration date
11/10/2005
Last updated
04/11/2019
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