Taylor Rene Russell

NPI #1235774381 in Farmington, Missouri

Provider Information

NPI Number: 1235774381
Entity Type: Individual
Name: Taylor Rene Russell
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Enumeration Date: Nov 13, 2019
Last Updated: Nov 13, 2019

Practice Location

Address: 1108 W LIBERTY ST
City: Farmington
State: Missouri
ZIP Code: 63640-1922
Phone: (573) 260-4136

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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