MRS. Blake Phillips Russell, MPT

NPI #1316472616 in Pacific Grove, California

Provider Information

NPI Number: 1316472616
Entity Type: Individual
Name: MRS. Blake Phillips Russell, MPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: MPT
Enumeration Date: Apr 24, 2017
Last Updated: Apr 24, 2017

Practice Location

Address: 220 COUNTRY CLUB GATE CTR
Address 2: SUITE 11
City: Pacific Grove
State: California
ZIP Code: 93950-5014
Phone: (831) 917-9886

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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