Individual
MR. RUSSELL BOARDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
363 HIGHLAND AVE, FALL RIVER, MA 02720-3703
(508) 679-3131
Mailing address
1003 MERIDIAN ST, FALL RIVER, MA 02720-4679
(508) 679-3131
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
910
MA
Other
Enumeration date
03/02/2007
Last updated
07/08/2007
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