Ericka N Russell, PTA

NPI #1336500974 in Ada, Oklahoma

Provider Information

NPI Number: 1336500974
Entity Type: Individual
Name: Ericka N Russell, PTA
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapy Assistant
Credential: PTA
Enumeration Date: Mar 10, 2016
Last Updated: Mar 10, 2016

Practice Location

Address: 511 N MONTE VISTA ST
City: Ada
State: Oklahoma
ZIP Code: 74820-4611
Phone: (580) 436-3633

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapy Assistant	225200000X	Primary

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