Individual
ADAM RUSSELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PTA
Contact information
Practice address
487 LAKE CONCORD RD NE, CONCORD, NC 28025-2934
(704) 403-0291
Mailing address
337 COURTLAND CT, KANNAPOLIS, NC 28081-7172
(704) 403-0291
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
5426
NC
Other
Enumeration date
11/20/2015
Last updated
11/20/2015
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