DR. Jacob Aaron Russell, PT, DPT

NPI #1356228142 in Benton, Illinois

Provider Information

NPI Number: 1356228142
Entity Type: Individual
Name: DR. Jacob Aaron Russell, PT, DPT
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physical Therapist
Credential: PT, DPT
Enumeration Date: Aug 21, 2025
Last Updated: Aug 28, 2025

Practice Location

Address: 1104 W MAIN ST
City: Benton
State: Illinois
ZIP Code: 62812-1565
Phone: (618) 439-3399

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physical Therapist	225100000X	Primary

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