Individual
GEORGE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PT
Contact information
Practice address
12961 LAFAYETTE ST UNIT H, THORNTON, CO 80241-3969
(720) 508-3422
Mailing address
247 REMUDA LN, LAFAYETTE, CO 80026-7006
(201) 638-3598
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
PTL0012394
CO
2251G0304X
Geriatric Physical Therapist
—
—
Other
Enumeration date
04/06/2015
Last updated
02/16/2025
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