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Individual

CYNTHIA L. RUSSELL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
PT

Contact information

Practice address
810 SAINT LOUIS RD, FULTON, MO 65251-2258
(573) 823-8743
Mailing address
810 SAINT LOUIS RD, FULTON, MO 65251-2258

Taxonomy

Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2002018261
MO

Other

Enumeration date
08/31/2007
Last updated
08/31/2007
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