Individual
MR. RUSSELL SCOTT GREGORY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
376 MANCHESTER SQUARE, MANCHESTER, KY 40962-9998
(606) 598-7673
(606) 598-7948
Mailing address
317 TOMCAT TRAIL, LONDON, KY 40741
(606) 862-4027
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
A01679
KY
Other
Enumeration date
10/03/2006
Last updated
07/08/2007
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