Mary Michelle Russell, PT

NPI #1083711808 in Orinda, California

Provider Information

NPI Number: 1083711808
Entity Type: Individual
Name: Mary Michelle Russell, PT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT
Enumeration Date: Sep 20, 2006
Last Updated: Nov 30, 2012

Practice Location

Address: 1 BATES BLVD STE 100
City: Orinda
State: California
ZIP Code: 94563-2800
Phone: (925) 254-8755

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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