Individual
ALEXANDRA DENISE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPT
Contact information
Practice address
225 PHYSICIANS PARK, SUITE 101, POPLAR BLUFF, MO 63901-3956
(573) 778-9348
(573) 686-4870
Mailing address
2725 N WESTWOOD BLVD, SUITE 17, POPLAR BLUFF, MO 63901-2346
(573) 778-9348
(573) 686-4870
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2010031805
MO
Other
Enumeration date
04/26/2011
Last updated
08/06/2013
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