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MR. JEFFREY ALAN RUSSELL PT, MS,

>> Physical Therapist >> Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Registrant NPI Number: 1053497065

Individual Registrant:
MR. JEFFREY ALAN RUSSELL PT, MS,
Gender: M
Not Sole Proprietor

Location and contact information for practice:
116 TRESTLE DRIVE  WINTER PARK, CO 80482-8048 US
Tel: 970-531-1582  Fax: --

Contact information for business:
PO BOX 743  WINTER PARK, CO 80482-0743 US
Tel: 970-531-1582  Fax: --

Registration Information:
NPI: 1053497065
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y225100000XRespiratory, Developmental, Rehabilitative and Restorative Service Providers
Physical Therapist
CO7458

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
68606770CO05




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