Individual
LAUREN K RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
680 KINGSBOROUGH SQ STE B, CHESAPEAKE, VA 23320-4988
(757) 547-0434
Mailing address
PO BOX 412307, BOSTON, MA 02241-2307
(914) 294-4050
Taxonomy
Speciality
Code
Description
License number
State
225100000X
Physical Therapist
Primary
2305213238
VA
225100000X
Physical Therapist
23658
MD
225100000X
Physical Therapist
292097
CA
Other
Enumeration date
06/21/2011
Last updated
06/18/2025
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