Individual
ERICA NICOLE RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 916-5102
Mailing address
3551 ROGER BROOKE DR, FORT SAM HOUSTON, TX 78234-4504
(210) 539-9582
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
1244428
TX
Other
Enumeration date
09/21/2016
Last updated
09/05/2023
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